Free Amendments to Several Official Forms are effective 12/1/2007. View the Notice and Amended Official Bankruptcy Forms. - Utah

UNITED STATES BANKRUPTCY COURT DISTRICT OF UTAH OFFICE OF THE CLERK
November 2, 2007 Notice TO: ALL MEMBERS OF THE BAR AND OTHER PARTIES IN INTEREST Subject: Proposed Amendments to Official Bankruptcy Forms At its September 2007 meeting, the Judicial Conference approved proposed amendments to Bankruptcy Official Forms 1, 3A, 3B, 4, 5, 6, 7, 10, 16A, 19, 21, 23, and 24. The amendments to the existing Official Forms will be effective on December 1, 2007. Attorneys who utilize petition software for bankruptcy forms should contact their vendors to ensue the amended forms are updated prior to December 1, 2007. Copies of the amended forms are available on the Court's website at www.utb.uscourts.gov and at the 350 South Main Street, Room 301, SLC, UT 84101. For complete committee notes relating to form changes, go to http://www.uscourts.gov/bkforms/index.html A summary of the form changes include: Official Form 1, Voluntary Petition: The ranges for estimated number of creditors, estimated assets, and estimated liabilities would be amended to assist the courts in fulfilling the new statistical reporting requirements of 28 U.S.C. sec. 159. A notice is provided advising the attorney that the attorney's signature constitutes a certification that the attorney has no knowledge after an inquiry that the information in the schedules filed with the petition is incorrect. Official Form 3A, Application and Order to Pay Filing Fee in Installements: Amended to direct the debtor to state that, until the filing fee is paid in full, the debtor will not make any additional payment or transfer any additional property to an attorney or any other person for services in connection with the case. Official Form 3B, Application for Waiver of Chapter 7 Filing Fee: Fed. R.Bankr. P.1006 adds a new subdivision (c). Official Form 3B is the form referenced in that subdivision, and is to be used by individual chapter 7 debtors when applying for a waiver of the filing fee. A corresponding standard order also is included. Official Form 4, List of Creditors Holding 20 Largest Unsecured Claims: Amended to require only the initials of a minor and not the full name if a creditor is a minor. Official Form 5, Involuntary Petition: The form has been amended to delete statistical information about the debtor that no longer is required, and to substitute check boxes similar to those on the voluntary petition form. Official Form 6, Schedules, including Schedules A through J: Amended to require

only the initials of a minor and not the full name. Schedules I and J would include a statement advising debtors that the income and expense amounts on the schedules may differ from the income and expense amounts listed on the means test forms. Official Form 7, Statement of Financial Affairs: Amended to require only the initials of a minor and not the full name. Official Form 10, Proof of Claim: Amended to provide more accurate addresses for transmittal of payments and notices, and indicate that a particular proof of claim has been replaced. Official Form 16A, Caption Amended to require that the title of the case include all names used by the debtor within the last eight years in conformity with § 727(a)(8). Official Form 19, Declaration and Signature of Non-Attorney Bankruptcy Petition Preparer: This form is new. It is derived from form 19B and replaces forms 19A and 19B (which forms are abrogated). Official Form 21, Statement of Social Security Number: A taxpayer who does not have a Social Security number would provide a taxpayer identification number on the form. Official Form 23, Debtor's Certification of Completion of Instructional Course Concerning Personal Financial Management: Amended to remind the debtor that the form should not be used to file a certification of pre-petition credit counseling. Official form 24, Certification to Court of Appeals by All Parties: Amended to include a signature line for the appellee and the appellee's attorney. Amendments to Court Issued Official Bankruptcy Notices (BNC Notices) Official Form B9, Notice of Commencement of Case under the Bankruptcy Code, Meeting of Creditors, and Deadlines: Amended in a variety of ways to implement the provisions of the Bankruptcy Abuse Prevention and Consumer Protection Act of 2005. Official Form B18, Discharge of Debtor: Amended to require that the title of the case include all names used by the debtor within the eight years prior to the filing of the petition in the case in conformity with § 727(a)(8) as amended by the Bankruptcy Abuse Prevention and Consumer Protection Act of 2005. If you have any questions regarding the forms please contact Brenda Dowler 801-5246635 or via email at [email protected].

B1 (Official Form 1) (12/07)
United States Bankruptcy Court _________________DISTRICT OF __________________ Name of Debtor (if individual, enter Last, First, Middle): All Other Names used by the Debtor in the last 8 years (include married, maiden, and trade names): Voluntary Petition Name of Joint Debtor (Spouse) (Last, First, Middle): All Other Names used by the Joint Debtor in the last 8 years (include married, maiden, and trade names):

Last four digits of Social-Security/Complete EIN or other Tax-I.D. No. (if more than one, state all): Street Address of Debtor (No. and Street, City, and State):

Last four digits of Social-Security/Complete EIN or other Tax-I.D. No. (if more than one, state all): Street Address of Joint Debtor (No. and Street, City, and State):

ZIP CODE County of Residence or of the Principal Place of Business: Mailing Address of Debtor (if different from street address): County of Residence or of the Principal Place of Business:

ZIP CODE

Mailing Address of Joint Debtor (if different from street address):

ZIP CODE Location of Principal Assets of Business Debtor (if different from street address above): Type of Debtor (Form of Organization) (Check one box.) Individual (includes Joint Debtors) See Exhibit D on page 2 of this form. Corporation (includes LLC and LLP) Partnership Other (If debtor is not one of the above entities, check this box and state type of entity below.) Nature of Business (Check one box.) Health Care Business Single Asset Real Estate as defined in 11 U.S.C. § 101(51B) Railroad Stockbroker Commodity Broker Clearing Bank Other ___________________________________ Tax-Exempt Entity (Check box, if applicable.) Debtor is a tax-exempt organization under Title 26 of the United States Code (the Internal Revenue Code). Filing Fee (Check one box.) Full Filing Fee attached. Filing Fee to be paid in installments (applicable to individuals only). Must attach signed application for the court's consideration certifying that the debtor is unable to pay fee except in installments. Rule 1006(b). See Official Form 3A. Filing Fee waiver requested (applicable to chapter 7 individuals only). Must attach signed application for the court's consideration. See Official Form 3B.

ZIP CODE ZIP CODE Chapter of Bankruptcy Code Under Which the Petition is Filed (Check one box.) Chapter 7 Chapter 9 Chapter 11 Chapter 12 Chapter 13 Chapter 15 Petition for Recognition of a Foreign Main Proceeding Chapter 15 Petition for Recognition of a Foreign Nonmain Proceeding Nature of Debts (Check one box.) Debts are primarily consumer debts, defined in 11 U.S.C. § 101(8) as "incurred by an individual primarily for a personal, family, or household purpose." Chapter 11 Debtors Debts are primarily business debts.

__________________________________________

Check one box: Debtor is a small business debtor as defined in 11 U.S.C. § 101(51D). Debtor is not a small business debtor as defined in 11 U.S.C. § 101(51D). Check if: Debtor's aggregate noncontingent liquidated debts (excluding debts owed to insiders or affiliates) are less than $2,190,000. ----------------------------------Check all applicable boxes: A plan is being filed with this petition. Acceptances of the plan were solicited prepetition from one or more classes of creditors, in accordance with 11 U.S.C. § 1126(b).
THIS SPACE IS FOR COURT USE ONLY

Statistical/Administrative Information Debtor estimates that funds will be available for distribution to unsecured creditors. Debtor estimates that, after any exempt property is excluded and administrative expenses paid, there will be no funds available for distribution to unsecured creditors. Estimated Number of Creditors 1-49 50-99 100-199 200-999 1,0005,000 5,00110,000 10,00125,000 25,00150,000 50,001100,000 Over 100,000

Estimated Assets $0 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1 million $1,000,001 to $10 million $10,000,001 to $50 million $50,000,001 to $100 million $100,000,001 to $500 million $500,000,001 to $1 billion More than $1 billion

Estimated Liabilities $0 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1 million $1,000,001 to $10 million $10,000,001 to $50 million $50,000,001 to $100 million $100,000,001 to $500 million $500,000,001 to $1 billion More than $1 billion

B1 (Official Form 1) (12/07) Name of Debtor(s): Voluntary Petition (This page must be completed and filed in every case.) All Prior Bankruptcy Cases Filed Within Last 8 Years (If more than two, attach additional sheet.) Location Case Number: Date Filed: Where Filed: Location Case Number: Date Filed: Where Filed: Pending Bankruptcy Case Filed by any Spouse, Partner, or Affiliate of this Debtor (If more than one, attach additional sheet.) Name of Debtor: Case Number: Date Filed: District: Exhibit A (To be completed if debtor is required to file periodic reports (e.g., forms 10K and 10Q) with the Securities and Exchange Commission pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 and is requesting relief under chapter 11.) Relationship: Judge: Exhibit B (To be completed if debtor is an individual whose debts are primarily consumer debts.)

Page 2

I, the attorney for the petitioner named in the foregoing petition, declare that I have informed the petitioner that [he or she] may proceed under chapter 7, 11, 12, or 13 of title 11, United States Code, and have explained the relief available under each such chapter. I further certify that I have delivered to the debtor the notice required by 11 U.S.C. § 342(b). X Signature of Attorney for Debtor(s) (Date)

Exhibit A is attached and made a part of this petition.

Exhibit C Does the debtor own or have possession of any property that poses or is alleged to pose a threat of imminent and identifiable harm to public health or safety? Yes, and Exhibit C is attached and made a part of this petition. No.

Exhibit D (To be completed by every individual debtor. If a joint petition is filed, each spouse must complete and attach a separate Exhibit D.) Exhibit D completed and signed by the debtor is attached and made a part of this petition. If this is a joint petition: Exhibit D also completed and signed by the joint debtor is attached and made a part of this petition.
Information Regarding the Debtor - Venue (Check any applicable box.) Debtor has been domiciled or has had a residence, principal place of business, or principal assets in this District for 180 days immediately preceding the date of this petition or for a longer part of such 180 days than in any other District. There is a bankruptcy case concerning debtor's affiliate, general partner, or partnership pending in this District. Debtor is a debtor in a foreign proceeding and has its principal place of business or principal assets in the United States in this District, or has no principal place of business or assets in the United States but is a defendant in an action or proceeding [in a federal or state court] in this District, or the interests of the parties will be served in regard to the relief sought in this District.

Certification by a Debtor Who Resides as a Tenant of Residential Property (Check all applicable boxes.) Landlord has a judgment against the debtor for possession of debtor's residence. (If box checked, complete the following.)

(Name of landlord that obtained judgment)

(Address of landlord) Debtor claims that under applicable nonbankruptcy law, there are circumstances under which the debtor would be permitted to cure the entire monetary default that gave rise to the judgment for possession, after the judgment for possession was entered, and Debtor has included with this petition the deposit with the court of any rent that would become due during the 30-day period after the filing of the petition. Debtor certifies that he/she has served the Landlord with this certification. (11 U.S.C. § 362(l)).

B1 (Official Form) 1 (12/07) Voluntary Petition (This page must be completed and filed in every case.) Signature(s) of Debtor(s) (Individual/Joint) I declare under penalty of perjury that the information provided in this petition is true and correct. [If petitioner is an individual whose debts are primarily consumer debts and has chosen to file under chapter 7] I am aware that I may proceed under chapter 7, 11, 12 or 13 of title 11, United States Code, understand the relief available under each such chapter, and choose to proceed under chapter 7. [If no attorney represents me and no bankruptcy petition preparer signs the petition] I have obtained and read the notice required by 11 U.S.C. § 342(b). I request relief in accordance with the chapter of title 11, United States Code, specified in this petition. X Signature of Debtor X Signature of Joint Debtor Telephone Number (if not represented by attorney)

Page 3 Name of Debtor(s): Signatures Signature of a Foreign Representative I declare under penalty of perjury that the information provided in this petition is true and correct, that I am the foreign representative of a debtor in a foreign proceeding, and that I am authorized to file this petition. (Check only one box.) I request relief in accordance with chapter 15 of title 11, United States Code. Certified copies of the documents required by 11 U.S.C. § 1515 are attached. Pursuant to 11 U.S.C. § 1511, I request relief in accordance with the chapter of title 11 specified in this petition. A certified copy of the order granting recognition of the foreign main proceeding is attached. X (Signature of Foreign Representative)

(Printed Name of Foreign Representative)

Date Date Signature of Attorney* X Signature of Attorney for Debtor(s) Printed Name of Attorney for Debtor(s) Firm Name Address Signature of Non-Attorney Bankruptcy Petition Preparer I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined in 11 U.S.C. § 110; (2) I prepared this document for compensation and have provided the debtor with a copy of this document and the notices and information required under 11 U.S.C. §§ 110(b), 110(h), and 342(b); and, (3) if rules or guidelines have been promulgated pursuant to 11 U.S.C. § 110(h) setting a maximum fee for services chargeable by bankruptcy petition preparers, I have given the debtor notice of the maximum amount before preparing any document for filing for a debtor or accepting any fee from the debtor, as required in that section. Official Form 19 is attached.

Telephone Number Date *In a case in which § 707(b)(4)(D) applies, this signature also constitutes a certification that the attorney has no knowledge after an inquiry that the information in the schedules is incorrect. Signature of Debtor (Corporation/Partnership) I declare under penalty of perjury that the information provided in this petition is true and correct, and that I have been authorized to file this petition on behalf of the debtor. The debtor requests the relief in accordance with the chapter of title 11, United States Code, specified in this petition. X Signature of Authorized Individual Printed Name of Authorized Individual Title of Authorized Individual Date X

Printed Name and title, if any, of Bankruptcy Petition Preparer Social-Security number (If the bankruptcy petition preparer is not an individual, state the Social-Security number of the officer, principal, responsible person or partner of the bankruptcy petition preparer.) (Required by 11 U.S.C. § 110.)

Address

Date Signature of bankruptcy petition preparer or officer, principal, responsible person, or partner whose Social-Security number is provided above. Names and Social-Security numbers of all other individuals who prepared or assisted in preparing this document unless the bankruptcy petition preparer is not an individual. If more than one person prepared this document, attach additional sheets conforming to the appropriate official form for each person. A bankruptcy petition preparer's failure to comply with the provisions of title 11 and the Federal Rules of Bankruptcy Procedure may result in fines or imprisonment or both. 11 U.S.C. § 110; 18 U.S.C. § 156.

B3A (Official Form 3A) (12/07)

United States Bankruptcy Court
_______________ District Of ______________
Case No. ___________________ Chapter ____________

In re _______________________________________, Debtor

APPLICATION TO PAY FILING FEE IN INSTALLMENTS
1. 2. 3. In accordance with Fed. R. Bankr. P. 1006, I apply for permission to pay the filing fee amounting to $______________ in installments. I am unable to pay the filing fee except in installments. Until the filing fee is paid in full, I will not make any additional payment or transfer any additional property to an attorney or any other person for services in connection with this case. I propose the following terms for the payment of the Filing Fee.* $ _____________________ Check one With the filing of the petition, or On or before ______________

4.

$ _____________________ on or before ________________________________________ $ _____________________ on or before ________________________________________ $ _____________________ on or before ________________________________________ * The number of installments proposed shall not exceed four (4), and the final installment shall be payable not later than 120 days after filing the petition. For cause shown, the court may extend the time of any installment, provided the last installment is paid not later than 180 days after filing the petition. Fed. R. Bankr. P. 1006(b)(2). I understand that if I fail to pay any installment when due, my bankruptcy case may be dismissed and I may not receive a discharge of my debts. __________________________________________________________ Signature of Debtor Date (In a joint case, both spouses must sign.)

5.

___________________________________________ Signature of Attorney Date ___________________________________________ Name of Attorney

__________________________________________________________ Signature of Joint Debtor (if any) Date ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------DECLARATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 U.S.C. § 110) I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined in 11 U.S.C. § 110; (2) I prepared this document for compensation and have provided the debtor with a copy of this document and the notices and information required under 11 U.S.C. §§ 110(b), 110(h), and 342(b); (3) if rules or guidelines have been promulgated pursuant to 11 U.S.C. § 110(h) setting a maximum fee for services chargeable by bankruptcy petition preparers, I have given the debtor notice of the maximum amount before preparing any document for filing for a debtor or accepting any fee from the debtor, as required under that section; and (4) I will not accept any additional money or other property from the debtor before the filing fee is paid in full. ___________________________________________________ __________________________ Printed or Typed Name and Title, if any, of Bankruptcy Petition Preparer Social-Security No. (Required by 11 U.S.C. § 110.) If the bankruptcy petition preparer is not an individual, state the name, title (if any), address, and social-security number of the officer, principal, responsible person, or partner who signs the document. ________________________________ ________________________________ Address

x__________________________________________________ Signature of Bankruptcy Petition Preparer

_____________________ Date

Names and Social-Security numbers of all other individuals who prepared or assisted in preparing this document, unless the bankruptcy petition preparer is not an individual:

If more than one person prepared this document, attach additional signed sheets conforming to the appropriate Official Form for each person. A bankruptcy petition preparer's failure to comply with the provisions of title 11 and the Federal Rules of Bankruptcy Procedure may result in fines or imprisonment or both. 11 U.S.C. § 110; 18 U.S.C. § 156.

B3A (Official Form 3A) (12/07) - Cont.

United States Bankruptcy Court
_______________ District Of ______________

In re _______________________________________, Debtor

Case No. ___________________

Chapter ____________

ORDER APPROVING PAYMENT OF FILING FEE IN INSTALLMENTS
G application. G
IT IS ORDERED that the debtor(s) may pay the filing fee in installments on the terms proposed in the foregoing

IT IS ORDERED that the debtor(s) shall pay the filing fee according to the following terms: Check one With the filing of the petition, or On or before ______________

$ _____________________

$ _____________________ on or before ________________________________________ $ _____________________ on or before ________________________________________ $ _____________________ on or before ________________________________________

G IT IS FURTHER ORDERED that until the filing fee is paid in full the debtor(s) shall not make any additional payment or transfer any additional property to an attorney or any other person for services in connection with this case.

BY THE COURT

Date: ____________________

__________________________________________ United States Bankruptcy Judge

B3B (Official Form 3B) (12/07)

APPLICATION FOR WAIVER OF THE CHAPTER 7 FILING FEE FOR INDIVIDUALS WHO CANNOT PAY THE FILING FEE IN FULL OR IN INSTALLMENTS The court fee for filing a case under chapter 7 of the Bankruptcy Code is $299. If you cannot afford to pay the full fee at the time of filing, you may apply to pay the fee in installments. A form, which is available from the bankruptcy clerk's office, must be completed to make that application. If your application to pay in installments is approved, you will be permitted to file your petition, generally completing payment of the fee over the course of four to six months. If you cannot afford to pay the fee either in full at the time of filing or in installments, you may request a waiver of the filing fee by completing this application and filing it with the Clerk of Court. A judge will decide whether you have to pay the fee. By law, the judge may waive the fee only if your income is less than 150 percent of the official poverty line applicable to your family size and you are unable to pay the fee in installments. You may obtain information about the poverty guidelines at www.uscourts.gov or in the bankruptcy clerk's office. Required information. Complete all items in the application, and attach requested schedules. Then sign the application on the last page. If you and your spouse are filing a joint bankruptcy petition, you both must provide information as requested and sign the application.

B3B (Official Form 3B) (12/07) -- Cont.

United States Bankruptcy Court _________ District of __________
In re: ___________________
Debtor(s)

Case No. ___________________
(if known)

APPLICATION FOR WAIVER OF THE CHAPTER 7 FILING FEE FOR INDIVIDUALS WHO CANNOT PAY THE FILING FEE IN FULL OR IN INSTALLMENTS Part A. Family Size and Income 1. Including yourself, your spouse, and dependents you have listed or will list on Schedule I (Current Income of Individual Debtors(s)), how many people are in your family? (Do not include your spouse if you are separated AND are not filing a joint petition.) __________ Restate the following information that you provided, or will provide, on Line 16 of Schedule I. Attach a completed copy of Schedule I, if it is available. Total Combined Monthly Income (Line 16 of Schedule I): 3. $_________

2.

State the monthly net income, if any, of dependents included in Question 1 above. Do not include any income already reported in Item 2. If none, enter $0. $_________

4.

Add the "Total Combined Monthly Income" reported in Question 2 to your dependents' monthly net income from Question 3. $_________

5.

Do you expect the amount in Question 4 to increase or decrease by more than 10% during the next 6 months? Yes ___ No ___ If yes, explain.

Part B. Monthly Expenses 6. EITHER (a) attach a completed copy of Schedule J (Schedule of Monthly Expenses), and state your total monthly expenses reported on Line 18 of that Schedule, OR (b) if you have not yet completed Schedule J, provide an estimate of your total monthly expenses. $ __________ 7. Do you expect the amount in Question 6 to increase or decrease by more than 10% during the next 6 months? Yes ___ No ___ If yes, explain.

Part C. Real and Personal Property EITHER (1) attach completed copies of Schedule A (Real Property) and Schedule B (Personal Property), OR (2) if you have not yet completed those schedules, answer the following questions. 8. 9. State the amount of cash you have on hand. $ __________

State below any money you have in savings, checking, or other accounts in a bank or other financial institution.
Bank or Other Financial Institution: Type of Account such as savings, checking, CD: Amount: $ __________ $ __________

_________________________ __________________________ _

___________________ ___________________

B3B (Official Form 3B) (12/07) -- Cont.

10. State below the assets owned by you. Do not list ordinary household furnishings and clothing.
Address: Home ____________________________ Amount owed on mortgages and liens: $ __________ ____________________________ Address: Other real estate ____________________________ Amount owed on mortgages and liens: $ __________ _____________________________ Motor vehicle Model/Year: ___________________ ____________________________ Motor vehicle Model/Year: ___________________ ____________________________ Other Description___________________ ___________________________ Value: $ __________ Amount owed: $ __________ Value: $ __________ Amount owed: $ __________ Value: $ __________ Amount owed: $ __________ Value: $ __________ Value: $ __________

11. State below any person, business, organization, or governmental unit that owes you money and the amount that is owed.
Name of Person, Business, or Organization that Owes You Money __________________________________ __________________________________ Amount Owed

$ __________ $ __________

Part D. Additional Information. 12. Have you paid an attorney any money for services in connection with this case, including the completion of this form, the bankruptcy petition, or schedules? Yes ___ No ___ If yes, how much have you paid? $ __________ 13. Have you promised to pay or do you anticipate paying an attorney in connection with your bankruptcy case? Yes ___ No ___ If yes, how much have you promised to pay or do you anticipate paying? $ __________ 14. Have you paid anyone other than an attorney (such as a bankruptcy petition preparer, paralegal, typing service, or another person) any money for services in connection with this case, including the completion of this form, the bankruptcy petition, or schedules? Yes ___ No ___ If yes, how much have you paid? $ __________ 15. Have you promised to pay or do you anticipate paying anyone other than an attorney (such as a bankruptcy petition preparer, paralegal, typing service, or another person) any money for services in connection with this case, including the completion of this form, the bankruptcy petition, or schedules? Yes ___ No ___ If yes, how much have you promised to pay or do you anticipate paying? $ __________ 16. Has anyone paid an attorney or other person or service in connection with this case, on your behalf? Yes ___ No ___ If yes, explain.

B3B (Official Form 3B) (12/07) -- Cont. 17. Have you previously filed for bankruptcy relief during the past eight years? Yes ___ No ___ Case Number (if known) ___________________ ___________________ Year filed _______ _______ Location of filing ______________ ______________ Did you obtain a discharge? (if known) Yes ____ Yes ____ No ____ Don't know ____ No ____ Don't know ____

18. Please provide any other information that helps to explain why you are unable to pay the filing fee in installments. 19. I (we) declare under penalty of perjury that I (we) cannot currently afford to pay the filing fee in full or in installments and that the foregoing information is true and correct. Executed on: ___________________ Date ___________________ Date ________________________________ Signature of Debtor ________________________________ Signature of Codebtor

-----------------------------------------------------------------------------------------------------------------------------------------------------DECLARATION AND SIGNATURE OF BANKRUPTCY PETITION PREPARER (See 11 U.S.C. § 110) I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined in 11 U.S.C. § 110; (2) I prepared this document for compensation and have provided the debtor with a copy of this document and the notices and information required under 11 U.S.C. §§ 110(b), 110(h), and 342(b); and (3) if rules or guidelines have been promulgated pursuant to 11 U.S.C. § 110(h) setting a maximum fee for services chargeable by bankruptcy petition preparers, I have given the debtor notice of the maximum amount before preparing any document for filing for a debtor or accepting any fee from the debtor, as required under that section. ___________________________________________________________ __________________________ Printed or Typed Name and Title, if any, of Bankruptcy Petition Preparer Social-Security No. (Required by 11 U.S.C. §110.) If the bankruptcy petition preparer is not an individual, state the name, title (if any), address, and social-security number of the officer, principal, responsible person, or partner who signs the document. ________________________________ ________________________________ Address x__________________________________________________ Signature of Bankruptcy Petition Preparer _____________________ Date

Names and Social-Security numbers of all other individuals who prepared or assisted in preparing this document, unless the bankruptcy petition preparer is not an individual:

If more than one person prepared this document, attach additional signed sheets conforming to the appropriate Official Form for each person. A bankruptcy petition preparer's failure to comply with the provisions of title 11 and the Federal Rules of Bankruptcy Procedure may result in fines or imprisonment or both. 11 U.S.C. § 110; 18 U.S.C. § 156.

B3B (Official Form 3B) (12/07) -- Cont.

United States Bankruptcy Court _________ District of __________
In re: ___________________ Debtor(s) Case No. ___________________

ORDER ON DEBTOR'S APPLICATION FOR WAIVER OF THE CHAPTER 7 FILING FEE Upon consideration of the debtor's "Application for Waiver of the Chapter 7 Filing Fee," the court orders that the application be: [ ] GRANTED. This order is subject to being vacated at a later time if developments in the administration of the bankruptcy case demonstrate that the waiver was unwarranted. [ ] DENIED. The debtor shall pay the chapter 7 filing fee according to the following terms: $ __________ on or before __________ $ __________ on or before __________ $ __________ on or before __________ $ __________ on or before __________ Until the filing fee is paid in full, the debtor shall not make any additional payment or transfer any additional property to an attorney or any other person for services in connection with this case. IF THE DEBTOR FAILS TO TIMELY PAY THE FILING FEE IN FULL OR TO TIMELY MAKE INSTALLMENT PAYMENTS, THE COURT MAY DISMISS THE DEBTOR'S CASE. [ ] SCHEDULED FOR HEARING. A hearing to consider the debtor's "Application for Waiver of the Chapter 7 Filing Fee" shall be held on __________________ at ________ am/pm at ________________________________________. (address of courthouse) IF THE DEBTOR FAILS TO APPEAR AT THE SCHEDULED HEARING, THE COURT MAY DEEM SUCH FAILURE TO BE THE DEBTOR'S CONSENT TO THE ENTRY OF AN ORDER DENYING THE FEE WAIVER APPLICATION BY DEFAULT. BY THE COURT: DATE: __________ __________________________ United States Bankruptcy Judge

B4 (Official Form 4) (12/07)

United States Bankruptcy Court
_______________ District Of ______________
In re ___________________________________, Debtor Case No. ___________________ Chapter ____________

LIST OF CREDITORS HOLDING 20 LARGEST UNSECURED CLAIMS
Following is the list of the debtor's creditors holding the 20 largest unsecured claims. The list is prepared in accordance with Fed. R. Bankr. P. 1007(d) for filing in this chapter 11 [or chapter 9] case. The list does not include (1) persons who come within the definition of "insider" set forth in 11 U.S.C. § 101, or (2) secured creditors unless the value of the collateral is such that the unsecured deficiency places the creditor among the holders of the 20 largest unsecured claims. If a minor child is one of the creditors holding the 20 largest unsecured claims, state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m).

______________________________________________________________________________
(1) Name of creditor and complete mailing address, including zip code (2) (3) (4) (5)

Name, telephone number and Nature of claim complete mailing address, (trade debt, bank including zip code, of loan, government employee, agent, or department contract, etc.) of creditor familiar with claim who may be contacted

Indicate if claim Amount of claim is contingent, [if secured also unliquidated, state value of disputed or security] subject to setoff

__________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

Date: __________________________ _______________________________________ Debtor

[Declaration as in Form 2]

B5 (Official Form 5) (12/07)

United States Bankruptcy Court ______________________District of______________________
IN RE (Name of Debtor ­ If Individual: Last, First, Middle)

INVOLUNTARY PETITION

ALL OTHER NAMES used by debtor in the last 8 years (Include married, maiden, and trade names.)

Last four digits of Social-Security or other Individual's Tax-I.D. No./Complete EIN (If more than one, state all.): STREET ADDRESS OF DEBTOR (No. and street, city, state, and zip code) MAILING ADDRESS OF DEBTOR (If different from street address)

COUNTY OF RESIDENCE OR PRINCIPAL PLACE OF BUSINESS ZIP CODE ZIP CODE

LOCATION OF PRINCIPAL ASSETS OF BUSINESS DEBTOR (If different from previously listed addresses) CHAPTER OF BANKRUPTCY CODE UNDER WHICH PETITION IS FILED

Chapter 7

Chapter 11
INFORMATION REGARDING DEBTOR (Check applicable boxes)

Nature of Debts (Check one box.) Petitioners believe:



Debts are primarily consumer debts Debts are primarily business debts



Type of Debtor (Form of Organization) Individual (Includes Joint Debtor) Corporation (Includes LLC and LLP) Partnership Other (If debtor is not one of the above entities, check this box and state type of entity below.)



_________________________________________ VENUE

Nature of Business (Check one box.) Health Care Business Single Asset Real Estate as defined in 11 U.S.C. § 101(51)(B) Railroad Stockbroker Commodity Broker Clearing Bank Other

FILING FEE (Check one box)



Debtor has been domiciled or has had a residence, principal place of business, or principal assets in the District for 180 days immediately preceding the date of this petition or for a longer part of such 180 days than in any other District. A bankruptcy case concerning debtor's affiliate, general partner or partnership is pending in this District.



Full Filing Fee attached



Petitioner is a child support creditor or its representative, and the form specified in § 304(g) of the Bankruptcy Reform Act of 1994 is attached. [If a child support creditor or its representative is a petitioner, and if the petitioner files the form specified in § 304(g) of the Bankruptcy Reform Act of 1994, no fee is required.]

Name of Debtor Relationship

PENDING BANKRUPTCY CASE FILED BY OR AGAINST ANY PARTNER OR AFFILIATE OF THIS DEBTOR (Report information for any additional cases on attached sheets.) Case Number Date District ALLEGATIONS (Check applicable boxes) Judge

COURT USE ONLY

1. 2.

Petitioner (s) are eligible to file this petition pursuant to 11 U.S.C. § 303 (b). The debtor is a person against whom an order for relief may be entered under title 11 of the United States Code. 3.a. The debtor is generally not paying such debtor's debts as they become due, unless such debts are the subject of a bona fide dispute as to liability or amount; or b. Within 120 days preceding the filing of this petition, a custodian, other than a trustee receiver, or agent appointed or authorized to take charge of less than substantially all of the property of the debtor for the purpose of enforcing a lien against such property, was appointed or took possession.

B5 (Official Form 5) (12/07) ­ Page 2

Name of Debtor______________________ Case No.____________________________
TRANSFER OF CLAIM

Check this box if there has been a transfer of any claim against the debtor by or to any petitioner. Attach all documents that

evidence the transfer and any statements that are required under Bankruptcy Rule 1003(a).
REQUEST FOR RELIEF Petitioner(s) request that an order for relief be entered against the debtor under the chapter of title 11, United States Code, specified in this petition. If any petitioner is a foreign representative appointed in a foreign proceeding, a certified copy of the order of the court granting recognition is attached. Petitioner(s) declare under penalty of perjury that the foregoing is true and correct according to the best of their knowledge, information, and belief. x__________________________________________________________ Signature of Petitioner or Representative (State title) Name of Petitioner Name & Mailing Address of Individual Signing in Representative Capacity Date Signed ______________________ ______________________ Telephone No. x______________________________________________________ Signature of Attorney Date Name of Attorney Firm (If any) _______________________________________________________ Address

x__________________________________________________________ Signature of Petitioner or Representative (State title) Name of Petitioner Name & Mailing Address of Individual Signing in Representative Capacity Date Signed ______________________ ______________________

x______________________________________________________ Signature of Attorney Date Name of Attorney Firm (If any) _______________________________________________________ Address Telephone No.

x__________________________________________________________ Signature of Petitioner or Representative (State title) Name of Petitioner Name & Mailing Address of Individual Signing in Representative Capacity Date Signed ______________________ ______________________

x______________________________________________________ Signature of Attorney Date Name of Attorney Firm (If any) _______________________________________________________ Address Telephone No.

Name and Address of Petitioner Name and Address of Petitioner Name and Address of Petitioner Note:

PETITIONING CREDITORS Nature of Claim Nature of Claim Nature of Claim

Amount of Claim Amount of Claim Amount of Claim Total Amount of Petitioners' Claims

If there are more than three petitioners, attach additional sheets with the statement under penalty of perjury, each petitioner's signature under the statement and the name of attorney and petitioning creditor information in the format above. ______continuation sheets attached

B6 Summary (Official Form 6 - Summary) (12/07)

United States Bankruptcy Court
_______________ District Of ______________
In re ___________________________________, Debtor Case No. ___________________ Chapter ____________

SUMMARY OF SCHEDULES
Indicate as to each schedule whether that schedule is attached and state the number of pages in each. Report the totals from Schedules A, B, D, E, F, I, and J in the boxes provided. Add the amounts from Schedules A and B to determine the total amount of the debtor's assets. Add the amounts of all claims from Schedules D, E, and F to determine the total amount of the debtor's liabilities. Individual debtors also must complete the "Statistical Summary of Certain Liabilities and Related Data" if they file a case under chapter 7, 11, or 13.
ATTACHED (YES/NO)

NAME OF SCHEDULE A - Real Property

NO. OF SHEETS $

ASSETS

LIABILITIES

OTHER

B - Personal Property

$

C - Property Claimed as Exempt D - Creditors Holding Secured Claims E - Creditors Holding Unsecured Priority Claims (Total of Claims on Schedule E) F - Creditors Holding Unsecured Nonpriority Claims $

$

$

G - Executory Contracts and Unexpired Leases

H - Codebtors

I - Current Income of Individual Debtor(s) J - Current Expenditures of Individual Debtors(s) TOTAL $ $

$

$

Form 6 - Statistical Summary (12/07)

United States Bankruptcy Court
_______________ District Of ______________

In re ___________________________________, Debtor

Case No. ___________________ Chapter ____________

STATISTICAL SUMMARY OF CERTAIN LIABILITIES AND RELATED DATA (28 U.S.C. § 159)
If you are an individual debtor whose debts are primarily consumer debts, as defined in § 101(8) of the Bankruptcy Code (11 U.S.C. § 101(8)), filing a case under chapter 7, 11 or 13, you must report all information requested below.

Q Check this box if you are an individual debtor whose debts are NOT primarily consumer debts. You are not required to report any information here.

This information is for statistical purposes only under 28 U.S.C. § 159.
Summarize the following types of liabilities, as reported in the Schedules, and total them.

Type of Liability Domestic Support Obligations (from Schedule E) Taxes and Certain Other Debts Owed to Governmental Units (from Schedule E) Claims for Death or Personal Injury While Debtor Was Intoxicated (from Schedule E) (whether disputed or undisputed) Student Loan Obligations (from Schedule F) Domestic Support, Separation Agreement, and Divorce Decree Obligations Not Reported on Schedule E Obligations to Pension or Profit-Sharing, and Other Similar Obligations (from Schedule F) TOTAL State the following: Average Income (from Schedule I, Line 16) Average Expenses (from Schedule J, Line 18) Current Monthly Income (from Form 22A Line 12; OR, Form 22B Line 11; OR, Form 22C Line 20 )

Amount $ $ $ $ $ $ $

$ $ $

State the following:
1. Total from Schedule D, "UNSECURED PORTION, IF ANY" column 2. Total from Schedule E, "AMOUNT ENTITLED TO PRIORITY" column. 3. Total from Schedule E, "AMOUNT NOT ENTITLED TO PRIORITY, IF ANY" column 4. Total from Schedule F 5. Total of non-priority unsecured debt (sum of 1, 3, and 4)

$ $ $ $ $

B6I (Official Form 6I) (12/07) In re Debtor , Case No. (if known)

SCHEDULE I - CURRENT INCOME OF INDIVIDUAL DEBTOR(S)
The column labeled "Spouse" must be completed in all cases filed by joint debtors and by every married debtor, whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed. Do not state the name of any minor child. The average monthly income calculated on this form may differ from the current monthly income calculated on From 22A, 22B, or 22C. Debtor's Marital Status: RELATIONSHIP(S): Employment: Occupation Name of Employer How long employed Address of Employer DEBTOR SPOUSE DEPENDENTS OF DEBTOR AND SPOUSE AGE(S):

INCOME: (Estimate of average or projected monthly income at time case filed) 1. Monthly gross wages, salary, and commissions (Prorate if not paid monthly) 2. Estimate monthly overtime 3. SUBTOTAL 4. LESS PAYROLL DEDUCTIONS a. Payroll taxes and social security b. Insurance c. Union dues d. Other (Specify): 5. SUBTOTAL OF PAYROLL DEDUCTIONS 6. TOTAL NET MONTHLY TAKE HOME PAY 7. Regular income from operation of business or profession or farm (Attach detailed statement) 8. Income from real property 9. Interest and dividends 10. Alimony, maintenance or support payments payable to the debtor for the debtor's use or that of dependents listed above 11. Social security or government assistance (Specify): 12. Pension or retirement income 13. Other monthly income (Specify): 14. SUBTOTAL OF LINES 7 THROUGH 13 15. AVERAGE MONTHLY INCOME (Add amounts on lines 6 and 14)

DEBTOR $________________ $________________

SPOUSE $______________ $______________

$_______________ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

$_____________

$ $

$ 16. COMBINED AVERAGE MONTHLY INCOME: (Combine column totals from line 15) (Report also on Summary of Schedules and, if applicable, on Statistical Summary of Certain Liabilities and Related Data) 17. Describe any increase or decrease in income reasonably anticipated to occur within the year following the filing of this document:

B6H (Official Form 6H) (12/07) In re Debtor , Case No. (if known)

SCHEDULE H - CODEBTORS
Provide the information requested concerning any person or entity, other than a spouse in a joint case, that is also liable on any debts listed by the debtor in the schedules of creditors. Include all guarantors and co-signers. If the debtor resides or resided in a community property state, commonwealth, or territory (including Alaska, Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington, or Wisconsin) within the eight-year period immediately preceding the commencement of the case, identify the name of the debtor's spouse and of any former spouse who resides or resided with the debtor in the community property state, commonwealth, or territory. Include all names used by the nondebtor spouse during the eight years immediately preceding the commencement of this case. If a minor child is a codebtor or a creditor, state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m). Check this box if debtor has no codebtors. NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR

B6G (Official Form 6G) (12/07) In re Debtor , Case No. (if known)

SCHEDULE G - EXECUTORY CONTRACTS AND UNEXPIRED LEASES
Describe all executory contracts of any nature and all unexpired leases of real or personal property. Include any timeshare interests. State nature of debtor's interest in contract, i.e., "Purchaser," "Agent," etc. State whether debtor is the lessor or lessee of a lease. Provide the names and complete mailing addresses of all other parties to each lease or contract described. If a minor child is a party to one of the leases or contracts, state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m). Check this box if debtor has no executory contracts or unexpired leases.

NAME AND MAILING ADDRESS, INCLUDING ZIP CODE, OF OTHER PARTIES TO LEASE OR CONTRACT.

DESCRIPTION OF CONTRACT OR LEASE AND NATURE OF DEBTOR'S INTEREST. STATE WHETHER LEASE IS FOR NONRESIDENTIAL REAL PROPERTY. STATE CONTRACT NUMBER OF ANY GOVERNMENT CONTRACT.

B6F (Official Form 6F) (12/07) In re __________________________________________, Debtor Case No. _________________________________ (if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS
State the name, mailing address, including zip code, and last four digits of any account number, of all entities holding unsecured claims without priority against the debtor or the property of the debtor, as of the date of filing of the petition. The complete account number of any account the debtor has with the creditor is useful to the trustee and the creditor and may be provided if the debtor chooses to do so. If a minor child is a creditor, state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m). Do not include claims listed in Schedules D and E. If all creditors will not fit on this page, use the continuation sheet provided. If any entity other than a spouse in a joint case may be jointly liable on a claim, place an "X" in the column labeled "Codebtor," include the entity on the appropriate schedule of creditors, and complete Schedule H - Codebtors. If a joint petition is filed, state whether the husband, wife, both of them, or the marital community may be liable on each claim by placing an "H," "W," "J," or "C" in the column labeled "Husband, Wife, Joint, or Community." If the claim is contingent, place an "X" in the column labeled "Contingent." If the claim is unliquidated, place an "X" in the column labeled "Unliquidated." If the claim is disputed, place an "X" in the column labeled "Disputed." (You may need to place an "X" in more than one of these three columns.) Report the total of all claims listed on this schedule in the box labeled "Total" on the last sheet of the completed schedule. Report this total also on the Summary of Schedules and, if the debtor is an individual with primarily consumer debts, report this total also on the Statistical Summary of Certain Liabilities and Related Data..

G Check this box if debtor has no creditors holding unsecured claims to report on this Schedule F.

UNLIQUIDATED

CONTINGENT

CODEBTOR

(See

instructions above.)

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

Subtotal' _____continuation sheets attached Total' (Use only on last page of the completed Schedule F.) (Report also on Summary of Schedules and, if applicable, on the Statistical Summary of Certain Liabilities and Related Data.)

DISPUTED
$ $

CREDITOR'S NAME, MAILING ADDRESS INCLUDING ZIP CODE, AND ACCOUNT NUMBER

HUSBAND, WIFE, JOINT, OR COMMUNITY

DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM. IF CLAIM IS SUBJECT TO SETOFF, SO STATE.

AMOUNT OF CLAIM

B6F (Official Form 6F) (12/07) - Cont. In re __________________________________________, Debtor Case No. _________________________________ (if known)

SCHEDULE F - CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS
(Continuation Sheet)

HUSBAND, WIFE, JOINT, OR COMMUNITY

UNLIQUIDATED

CONTINGENT

CODEBTOR

(See

instructions above.)

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

ACCOUNT NO.

Sheet no.___of___ continuation sheets attached to Schedule of Creditors Holding Unsecured Nonpriority Claims

Subtotal'

DISPUTED
$ $

CREDITOR'S NAME, MAILING ADDRESS INCLUDING ZIP CODE, AND ACCOUNT NUMBER

DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM. IF CLAIM IS SUBJECT TO SETOFF, SO STATE.

AMOUNT OF CLAIM

Total' (Use only on last page of the completed Schedule F.) (Report also on Summary of Schedules and, if applicable on the Statistical Summary of Certain Liabilities and Related Data.)

B6E (Official Form 6E) (12/07) In re Debtor , Case No. (if known)

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS
A complete list of claims entitled to priority, listed separately by type of priority, is to be set forth on the sheets provided. Only holders of unsecured claims entitled to priority should be listed in this schedule. In the boxes provided on the attached sheets, state the name, mailing address, including zip code, and last four digits of the account number, if any, of all entities holding priority claims against the debtor or the property of the debtor, as of the date of the filing of the petition. Use a separate continuation sheet for each type of priority and label each with the type of priority. The complete account number of any account the debtor has with the creditor is useful to the trustee and the creditor and may be provided if the debtor chooses to do so. If a minor child is a creditor, state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m). If any entity other than a spouse in a joint case may be jointly liable on a claim, place an "X" in the column labeled "Codebtor," include the entity on the appropriate schedule of creditors, and complete Schedule H-Codebtors. If a joint petition is filed, state whether the husband, wife, both of them, or the marital community may be liable on each claim by placing an "H," "W," "J," or "C" in the column labeled "Husband, Wife, Joint, or Community." If the claim is contingent, place an "X" in the column labeled "Contingent." If the claim is unliquidated, place an "X" in the column labeled "Unliquidated." If the claim is disputed, place an "X" in the column labeled "Disputed." (You may need to place an "X" in more than one of these three columns.) Report the total of claims listed on each sheet in the box labeled "Subtotals" on each sheet. Report the total of all claims listed on this Schedule E in the box labeled "Total" on the last sheet of the completed schedule. Report this total also on the Summary of Schedules. Report the total of amounts entitled to priority listed on each sheet in the box labeled "Subtotals" on each sheet. Report the total of all amounts entitled to priority listed on this Schedule E in the box labeled "Totals" on the last sheet of the completed schedule. Individual debtors with primarily consumer debts report this total also on the Statistical Summary of Certain Liabilities and Related Data. Report the total of amounts not entitled to priority listed on each sheet in the box labeled "Subtotals" on each sheet. Report the total of all amounts not entitled to priority listed on this Schedule E in the box labeled "Totals" on the last sheet of the completed schedule. Individual debtors with primarily consumer debts report this total also on the Statistical Summary of Certain Liabilities and Related Data. Check this box if debtor has no creditors holding unsecured priority claims to report on this Schedule E.

TYPES OF PRIORITY CLAIMS (Check the appropriate box(es) below if claims in that category are listed on the attached sheets.)
Domestic Support Obligations Claims for domestic support that are owed to or recoverable by a spouse, former spouse, or child of the debtor, or the parent, legal guardian, or responsible relative of such a child, or a governmental unit to whom such a domestic support claim has been assigned to the extent provided in 11 U.S.C. § 507(a)(1). Extensions of credit in an involuntary case Claims arising in the ordinary course of the debtor's business or financial affairs after the commencement of the case but before the earlier of the appointment of a trustee or the order for relief. 11 U.S.C. § 507(a)(3). Wages, salaries, and commissions Wages, salaries, and commissions, including vacation, severance, and sick leave pay owing to employees and commissions owing to qualifying independent sales representatives up to $10,950* per person earned within 180 days immediately preceding the filing of the original petition, or the cessation of business, whichever occurred first, to the extent provided in 11 U.S.C. § 507(a)(4). Contributions to employee benefit plans Money owed to employee benefit plans for services rendered within 180 days immediately preceding the filing of the original petition, or the cessation of business, whichever occurred first, to the extent provided in 11 U.S.C. § 507(a)(5).

B6E (Official Form 6E) (12/07) ­ Cont. In re Debtor , Case No. (if known)

Certain farmers and fishermen Claims of certain farmers and fishermen, up to $5,400* per farmer or fisherman, against the debtor, as provided in 11 U.S.C. § 507(a)(6).

Deposits by individuals Claims of individuals up to $2,425* for deposits for the purchase, lease, or rental of property or services for personal, family, or household use, that were not delivered or provided. 11 U.S.C. § 507(a)(7).

Taxes and Certain Other Debts Owed to Governmental Units Taxes, customs duties, and penalties owing to federal, state, and local governmental units as set forth in 11 U.S.C. § 507(a)(8).

Commitments to Maintain the Capital of an Insured Depository Institution Claims based on commitments to the FDIC, RTC, Director of the Office of Thrift Supervision, Comptroller of the Currency, or Board of Governors of the Federal Reserve System, or their predecessors or successors, to maintain the capital of an insured depository institution. 11 U.S.C. § 507 (a)(9).

Claims for Death or Personal Injury While Debtor Was Intoxicated Claims for death or personal injury resulting from the operation of a motor vehicle or vessel while the debtor was intoxicated from using alcohol, a drug, or another substance. 11 U.S.C. § 507(a)(10).

* Amounts are subject to adjustment on April 1, 2010, and every three years thereafter with respect to cases commenced on or after the date of adjustment.

____ continuation sheets attached

B6E (Official Form 6E) (12/07) ­ Cont. In re __________________________________________, Debtor Case No. _________________________________ (if known)

SCHEDULE E - CREDITORS HOLDING UNSECURED PRIORITY CLAIMS
(Continuation Sheet) Type of Priority for Claims Listed on This Sheet
HUSBAND, WIFE, JOINT, OR COMMUNITY

CONTINGENT

Account No.

Account No.

Account No.

Account No.

CODEBTOR

Sheet no. ___ of ___ continuation sheets attached to Schedule of Creditors Holding Priority Claims

Subtotals' (Totals of this page) Total' (Use only on last page of the completed Schedule E. Report also on the Summary of Schedules.) Totals' (Use only on last page of the completed Schedule E. If applicable, report also on the Statistical Summary of Certain Liabilities and Related Data.)

DISPUTED

CREDITOR'S NAME, MAILING ADDRESS INCLUDING ZIP CODE, AND ACCOUNT NUMBER (See instructions above.)

DATE CLAIM WAS INCURRED AND CONSIDERATION FOR CLAIM

UNLIQUIDATED

AMOUNT OF CLAIM

AMOUNT ENTITLED TO PRIORITY

AMOUNT NOT ENTITLED TO PRIORITY, IF ANY

$

$

$

$

$

B6D (Official Form 6D) (12/07) In re ____________________________________, Debtor Case No. __________________________________ (If known)

SCHEDULE D - CREDITORS HOLDING SECURED CLAIMS
State the name, mailing address, including zip code, and last four digits of any account number of all entities holding claims secured by property of the debtor as of the date of filing of the petition. The complete account number of any account the debtor has with the creditor is useful to the trustee and the creditor and may be provided if the debtor chooses to do so. List creditors holding all types of secured interests such as judgment liens, garnishments, statutory liens, mortgages, deeds of trust, and other security interests. List creditors in alphabetical order to the extent practicable. If a minor child is the creditor, state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m). If all secured creditors will not fit on this page, use the continuation sheet provided. If any entity other than a spouse in a joint case may be jointly liable on a claim, place an "X" in the column labeled "Codebtor," include the entity on the appropriate schedule of creditors, and complete Schedule H ­ Codebtors. If a joint petition is filed, state whether the husband, wife, both of them, or the marital community may be liable on each claim by placing an "H," "W," "J," or "C" in the column labeled "Husband, Wife, Joint, or Community." If the claim is contingent, place an "X" in the column labeled "Contingent." If the claim is unliquidated, place an "X" in the column labeled "Unliquidated." If the claim is disputed, place an "X" in the column labeled "Disputed." (You may need to place an "X" in more than one of these three columns.) Total the columns labeled "Amount of Claim Without Deducting Value of Collateral" and "Unsecured Portion, if Any" in the boxes labeled "Total(s)" on the last sheet of the completed schedule. Report the total from the column labeled "Amount of Claim Without Deducting Value of Collateral" also on the Summary of Schedules and, if the debtor is an individual with primarily consumer debts, report the total from the column labeled "Unsecured Portion, if Any" on the Statistical Summary of Certain Liabilities and Related Data.



Check this box if debtor has no creditors holding secured claims to report on this Schedule D.

HUSBAND, WIFE, JOINT, OR COMMUNITY

CONTINGENT

CODEBTOR

ACCOUNT NO.

VALUE $ ACCOUNT NO.

VALUE $ ACCOUNT NO.

____continuation sheets
attached

VALUE $ Subtotal (Total of this page) Total (Use only on last page)

DISPUTED

CREDITOR'S NAME AND MAILING ADDRESS INCLUDING ZIP CODE AND AN ACCOUNT NUMBER (See Instructions Above.)

DATE CLAIM WAS INCURRED, NATURE OF LIEN , AND DESCRIPTION AND VALUE OF PROPERTY SUBJECT TO LIEN

UNLIQUIDATED

AMOUNT OF CLAIM WITHOUT DEDUCTING VALUE OF COLLATERAL

UNSECURED PORTION, IF ANY

$ $
(Report also on Summary of Schedules.)

$ $
(If applicable, report also on Statistical Summary of Certain Liabilities and Related Data.)

B6D (Official Form 6D) (12/07) ­ Cont. In re ____________________________________, Debtor Case No. __________________________________ (if known)

2

SCHEDULE D - CREDITORS HOLDING SECURED CLAIMS
(Continuation Sheet)

HUSBAND, WIFE, JOINT, OR COMMUNITY

CONTINGENT

CODEBTOR

CREDITOR'S NAME AND MAILING ADDRESS INCLUDING ZIP CODE AND AN ACCOUNT NUMBER (See Instructions Above.)

DATE CLAIM WAS INCURRED, NATURE OF LIEN , AND DESCRIPTION AND VALUE OF PROPERTY SUBJECT TO LIEN

UNLIQUIDATED

ACCOUNT NO.

VALUE $ ACCOUNT NO.

VALUE $ ACCOUNT NO.

VALUE $ ACCOUNT NO.

VALUE $ ACCOUNT NO.

VALUE $ Sheet no.___of___continuation sheets attached to Schedule of Creditors Holding Secured Claims Subtotal (s) (Total(s) of this page) Total(s) (Use only on last page)

DISPUTED

AMOUNT OF CLAIM WITHOUT DEDUCTING VALUE OF COLLATERAL

UNSECURED PORTION, IF ANY

$

$

$
(Report also on Summary of Schedules.)

$
(If applicable, report also on Statistical Summary of Certain Liabilities and Related Data.)

B6C (Official Form 6C) (12/07)
In re ____________________________________________, Debtor Case No. _________________________ (If known)

SCHEDULE C - PROPERTY CLAIMED AS EXEMPT
Debtor claims the exemptions to which debtor is entitled under: (Check one box) G 11 U.S.C. § 522(b)(2) G 11 U.S.C. § 522(b)(3)

G Check if debtor claims a homestead exemption that exceeds $136,875.

DESCRIPTION OF PROPERTY

SPECIFY LAW PROVIDING EACH EXEMPTION

VALUE OF CLAIMED EXEMPTION

CURRENT VALUE OF PROPERTY WITHOUT DEDUCTING EXEMPTION

B6B (Official Form 6B) (12/07)
In re _______________________________________________, Debtor Case No. _________________________ (If known)

SCHEDULE B - PERSONAL PROPERTY
Except as directed below, list all personal property of the debtor of whatever kind. If the debtor has no property in one or more of the categories, place an "x" in the appropriate position in the column labeled "None." If additional space is needed in any category, attach a separate sheet properly identified with the case name, case number, and the number of the category. If the debtor is married, state whether the husband, wife, both, or the marital community own the property by placing an "H," "W," "J," or "C" in the column labeled "Husband, Wife, Joint, or Community." If the debtor is an individual or a joint petition is filed, state the amount of any exemptions claimed only in Schedule C - Property Claimed as Exempt. Do not list interests in executory contracts and unexpired leases on this schedule. List them in Schedule G - Executory Contracts and Unexpired Leases. If the property is being held for the debtor by someone else, state that person's name and address under "Description and Location of Property." If the property is being held for a minor child, simply state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m).
CURRENT VALUE OF DEBTOR'S INTEREST IN PROPERTY, WITHOUT DEDUCTING ANY SECURED CLAIM OR EXEMPTION

TYPE OF PROPERTY

N O N E

DESCRIPTION AND LOCATION OF PROPERTY

1. Cash on hand. 2. Checking, savings or other financial accounts, certificates of deposit or shares in banks, savings and loan, thrift, building and loan, and homestead associations, or credit unions, brokerage houses, or cooperatives. 3. Security deposits with public utilities, telephone companies, landlords, and others. 4. Household goods and furnishings, including audio, video, and computer equipment. 5. Books; pictures and other art objects; antiques; stamp, coin, record, tape, compact disc, and other collections or collectibles. 6. Wearing apparel. 7. Furs and jewelry. 8. Firearms and sports, photographic, and other hobby equipment. 9. Interests in insurance policies. Name insurance company of each policy and itemize surrender or refund value of each. 10. Annuities. Itemize and name each issuer. 11. Interests in an education IRA as defined in 26 U.S.C. § 530(b)(1) or under a qualified State tuition plan as defined in 26 U.S.C. § 529(b)(1). Give particulars. (File separately the record(s) of any such interest(s). 11 U.S.C. § 521(c).)

B6B (Official Form 6B) (12/07) -- Cont.

In re ______________________________________________, Debtor

Case No. _________________________ (If known)

SCHEDULE B - PERSONAL PROPERTY
(Continuation Sheet)
CURRENT VALUE OF DEBTOR'S INTEREST IN PROPERTY, WITHOUT DEDUCTING ANY SECURED CLAIM OR EXEMPTION

TYPE OF PROPERTY

N O N E

DESCRIPTION AND LOCATION OF PROPERTY

12. Interests in IRA, ERISA, Keogh, or other pension or profit sharing plans. Give particulars. 13. Stock and interests in incorporated and unincorporated businesses. Itemize. 14. Interests in partnerships or joint ventures. Itemize. 15. Government and corporate bonds and other negotiable and nonnegotiable instruments. 16. Accounts receivable. 17. Alimony, maintenance, support, and property settlements to which the debtor is or may be entitled. Give particulars. 18. Other liquidated debts owed to debtor including tax refunds. Give particulars. 19. Equitable or future interests, life estates, and rights or powers exercisable for the benefit of the debtor other than those listed in Schedule A ­ Real Property. 20. Contingent and noncontingent interests in estate of a decedent, death benefit plan, life insurance policy, or trust. 21. Other contingent and unliquidated claims of every nature, including tax refunds, counterclaims of the debtor, and rights to setoff claims. Give estimated value of each.

B6B (Official Form 6B) (12/07) -- Cont.
In re _________________________________________________, Debtor Case No. _________________________ (If known)

SCHEDULE B - PERSONAL PROPERTY
(Continuation Sheet)

TYPE OF PROPERTY

N O N E

DESCRIPTION AND LOCATION OF PROPERTY

CURRENT VALUE OF DEBTOR'S INTEREST IN PROPERTY, WITHOUT DEDUCTING ANY SECURED CLAIM OR EXEMPTION

22. Patents, copyrights, and other intellectual property. Give particulars. 23. Licenses, franchises, and other general intangibles. Give particulars. 24. Customer lists or other compilations containing personally identifiable information (as defined in 11 U.S.C. § 101(41A)) provided to the debtor by individuals in connection with obtaining a product or service from the debtor primarily for personal, family, or household purposes. 25. Automobiles, trucks, trailers, and other vehicles and accessories. 26. Boats, motors, and accessories. 27. Aircraft and accessories. 28. Office equipment, furnishings, and supplies.

29. Machinery, fixtures, equipment, and supplies used in business.

30. Inventory.

31. Animals.

32. Crops - growing or harvested. Give particulars.

33. Farming equipment and implements.

34. Farm supplies, chemicals, and feed. 35. Other personal property of any kind not already listed. Itemize.

__________continuation sheets attached

Total'

$

(Include amounts from any continuation sheets attached. Report total also on Summary of Schedules.)

B6A (Official Form 6A) (12/07)
In re _____________________________________________, Debtor Case No. ______________________________ (If known)

SCHEDULE A - REAL PROPERTY
Except as directed below, list all real property in which the debtor has any legal, equitable, or future interest, including all property owned as a cotenant, community property, or in which the debtor has a life estate. Include any property in which the debtor holds rights and powers exercisable for the debtor's own benefit. If the debtor is married, state whether the husband, wife, both, or the marital community own the property by placing an "H," "W," "J," or "C" in the column labeled "Husband, Wife, Joint, or Community." If the debtor holds no interest in real property, write "None" under "Description and Location of Property." Do not include interests in executory contracts and unexpired leases on this schedule. List them in Schedule G - Executory Contracts and Unexpired Leases. If an entity claims to have a lien or hold a secured interest in any property, state the amount of the secured claim. See Schedule D. If no entity claims to hold a secured interest in the property, write "None" in the column labeled "Amount of Secured Claim." If the debtor is an individual or if a joint petition is filed, state the amount of any exemption claimed in the property only in Schedule C - Property Claimed as Exempt.

DESCRIPTION AND LOCATION OF PROPERTY

NATURE OF DEBTOR'S INTEREST IN PROPERTY

CURRENT VALUE OF DEBTOR'S INTEREST IN PROPERTY, WITHOUT DEDUCTING ANY SECURED CLAIM OR EXEMPTION

AMOUNT OF SECURED CLAIM

Total' (Report also on Summary of Schedules.)

B6J (Official Form 6J) (12/07) In re Debtor , Case No. (if known)

SCHEDULE J - CURRENT EXPENDITURES OF INDIVIDUAL DEBTOR(S)
Complete this schedule by estimating the average or projected monthly expenses of the debtor and the debtor's family at time case filed. Prorate any payments made biweekly, quarterly, semi-annually, or annually to show monthly rate. The average monthly expenses calculated on this form may differ from the deductions from income allowed on Form22A or 22C. Check this box if a joint petition is filed and debtor's spouse maintains a separate household. Complete a separate schedule of expenditures labeled "Spouse." 1. Rent or home mortgage payment (include lot rented for mobile home) a. Are real estate taxes included? b. Is property insurance included? 2. Utilities: a. Electricity and heating fuel b. Water and sewer c. Telephone d. Other ___________________________________________________________________ 3. Home maintenance (repairs and upkeep) 4. Food 5. Clothing 6. Laundry and dry cleaning 7. Medical and dental expenses 8. Transportation (not including car payments) 9. Recreation, clubs and entertainment, newspapers, magazines, etc. 10.Charitable contributions 11.Insurance (not deducted from wages or included in home mortgage payments) a. Homeowner's or renter's b. Life c. Health d. Auto e. Other ___________________________________________________________________ 12. Taxes (not deducted from wages or included in home mortgage payments) (Specify) ___________________________________________________________________________ 13. Installment payments: (In chapter 11, 12, and 13 cases, do not list payments to be included in the plan) a. Auto b. Other ______________________________________________________________ c. Other ____________________________________________________________ 14. Alimony, maintenance, and support paid to others 15. Payments for support of additional dependents not living at your home 16. Regular expenses from operation of business, profession, or farm (attach detailed statement) 17. Other __________________________________________________________________________ 18. AVERAGE MONTHLY EXPENSES (Total lines 1-17. Report also on Summary of Schedules and, if applicable, on the Statistical Summary of Certain Liabilities and Related Data.) 19. Describe any increase or decrease in expenditures reasonably anticipated to occur within the year following the filing of this document: ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ 20. STATEMENT OF MONTHLY NET INCOME a. Average monthly income from Line 15 of Schedule I b. Average monthly expenses from Line 18 above c. Monthly net income (a. minus b.) $______________ $______________ $______________ $ ______________ $ ______________ $ ______________ $ ______________ $ ______________ $ ______________ $______________ $ ______________ $ ______________ $ ______________ $ ______________ $ ______________ $ ______________ Yes ________ Yes ________ No ________ No ________ $ ______________ $ ______________ $ ______________ $ ______________ $ ______________ $ ______________ $ ______________ $ ______________ $ ______________ $ ______________ $ ______________ $ ______________ $ _____________

$______________

B7 (Official Form 7) (12/07)

UNITED STATES BANKRUPTCY COURT

______________________________ DISTRICT OF _____________________________

In re:_____ ___________________________________,
Debtor

Case No. ___________________________________
(if known)

STATEMENT OF FINANCIAL AFFAIRS
This statement is to be completed by every debtor. Spouses filing a joint petition may file a single statement on which the information for both spouses is combined. If the case is filed under chapter 12 or chapter 13, a married debtor must furnish information for both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed. An individual debtor engaged in business as a sole proprietor, partner, family farmer, or self-employed professional, should provide the information requested on this statement concerning all such activities as well as the individual's personal affairs. To indicate payments, transfers and the like to minor children, state the child's initials and the name and address of the child's parent or guardian, such as "A.B., a minor child, by John Doe, guardian." Do not disclose the child's name. See, 11 U.S.C. §112 and Fed. R. Bankr. P. 1007(m). Questions 1 - 18 are to be completed by all debtors. Debtors that are or have been in business, as defined below, also must complete Questions 19 - 25. If the answer to an applicable question is "None," mark the box labeled "None." If additional space is needed for the answer to any question, use and attach a separate sheet properly identified with the case name, case number (if known), and the number of the question.

DEFINITIONS "In business." A debtor is "in business" for the purpose of this form if the debtor is a corporation or partnership. An individual debtor is "in business" for the purpose of this form if the debtor is or has been, within six years immediately preceding the filing of this bankruptcy case, any of the following: an officer, director, managing executive, or owner of 5 percent or more of the voting or equity securities of a corporation; a partner, other than a limited partner, of a partnership; a sole proprietor or self-employed full-time or part-time. An individual debtor also may be "in business" for the purpose of this form if the debtor engages in a trade, business, or other activity, other than as an employee, to supplement income from the debtor's primary employment. "Insider." The term "insider" includes but is not limited to: relatives of the debtor; general partners of the debtor and their relatives; corporations of which the debtor is an officer, director, or person in control; officers, directors, and any owner of 5 percent or more of the voting or equity securities of a corporate debtor and their relatives; affiliates of the debtor and insiders of such affiliates; any managing agent of the debtor. 11 U.S.C. § 101. ______________________________________________________________________________________________________ 1. Income from employment or operation of business
None

State the gross amount of income the debtor has received from employment, trade, or profession, or from operation of the debtor's business, including part-time activities either as an employee or in independent trade or business, from the beginning of this calendar year to the date this case was commenced. State also the gross amounts received during the two years immediately preceding this calendar year. (A debtor that maintains, or has maintained, financial records on the basis of a fiscal rather than a calendar year may report fiscal year income. Identify the beginning and ending dates of the debtor's fiscal year.) If a joint petition is filed, state income for each spouse separately. (Married debtors filing under chapter 12 or chapter 13 must state income of both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) AMOUNT SOURCE

2
2.
None

Income other than from employment or operation of business

State the amount of income received by the debtor other than from employment, trade, profession, operation of the debtor's business during the two years immediately preceding the commencement of this case. Give particulars. If a joint petition is filed, state income for each spouse separately. (Married debtors filing under chapter 12 or chapter 13 must state income for each spouse whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) AMOUNT SOURCE

_____________________________________________________________________________________________________ 3. Payments to creditors Complete a. or b., as appropriate, and c.
None

a. Individual or joint debtor(s) with primarily consumer debts: List all payments on loans, installment purchases of goods or services, and other debts to any creditor made within 90 days immediately preceding the commencement of this case unless the aggregate value of all property that constitutes or is affected by such transfer is less than $600. Indicate with an asterisk (*) any payments that were made to a creditor on account of a domestic support obligation or as part of an alternative repayment schedule under a plan by an approved nonprofit budgeting and credit counseling agency. (Married debtors filing under chapter 12 or chapter 13 must include payments by either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) NAME AND ADDRESS OF CREDITOR DATES OF PAYMENTS AMOUNT PAID AMOUNT STILL OWING

______________________________________________________________________________________________________
None

G

b. Debtor whose debts are not primarily consumer debts: List each payment or other transfer to any creditor made within 90 days immediately preceding the commencement of the case unless the aggregate value of all property that constitutes or is affected by such transfer is less than $5,475. If the debtor is an individual, indicate with an asterisk (*) any payments that were made to a creditor on account of a domestic support obligation or as part of an alternative repayment schedule under a plan by an approved nonprofit budgeting and credit counseling agency. (Married debtors filing under chapter 12 or chapter 13 must include payments and other transfers by either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) NAME AND ADDRESS OF CREDITOR DATES OF PAYMENTS/ TRANSFERS AMOUNT PAID OR VALUE OF TRANSFERS AMOUNT STILL OWING

________________________________________________________________________________________________

3
None

G

c. All debtors: List all payments made within one year immediately preceding the commencement of this case to or for the benefit of creditors who are or were insiders. (Married debtors filing under chapter 12 or chapter 13 must include payments by either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) NAME AND ADDRESS OF CREDITOR AND RELATIONSHIP TO DEBTOR DATE OF PAYMENT AMOUNT PAID AMOUNT STILL OWING

______________________________________________________________________________________________________

4. Suits and administrative proceedings, executions, garnishments and attachments
None

a. List all suits and administrative proceedings to which the debtor is or was a party within one year immediately preceding the filing of this bankruptcy case. (Married debtors filing under chapter 12 or chapter 13 must include information concerning either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) CAPTION OF SUIT AND CASE NUMBER COURT OR AGENCY AND LOCATION STATUS OR DISPOSITION

NATURE OF PROCEEDING

______________________________________________________________________________________________________
None

b. Describe all property that has been attached, garnished or seized under any legal or equitable process within one year immediately preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include information concerning property of either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) NAME AND ADDRESS OF PERSON FOR WHOSE BENEFIT PROPERTY WAS SEIZED DESCRIPTION AND VALUE OF PROPERTY

DATE OF SEIZURE

_____________________________________________________________________________________________________ 5.
None

Repossessions, foreclosures and returns

List all property that has been repossessed by a creditor, sold at a foreclosure sale, transferred through a deed in lieu of foreclosure or returned to the seller, within one year immediately preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include information concerning property of either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) DATE OF REPOSSESSION, FORECLOSURE SALE, TRANSFER OR RETURN DESCRIPTION AND VALUE OF PROPERTY

NAME AND ADDRESS OF CREDITOR OR SELLER

_ ______________________________________________________________________________________________________

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6.
None

Assignments and receiverships

a. Describe any assignment of property for the benefit of creditors made within 120 days immediately preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include any assignment by either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) TERMS OF ASSIGNMENT OR SETTLEMENT

NAME AND ADDRESS OF ASSIGNEE

DATE OF ASSIGNMENT

________________________________________________________________________________________________
None

b. List all property which has been in the hands of a custodian, receiver, or court-appointed official within one year immediately preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include information concerning property of either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) NAME AND LOCATION OF COURT CASE TITLE & NUMBER DESCRIPTION AND VALUE Of PROPERTY

NAME AND ADDRESS OF CUSTODIAN

DATE OF ORDER

______________________________________________________________________________________________________ 7.
None

Gifts

List all gifts or charitable contributions made within one year immediately preceding the commencement of this case except ordinary and usual gifts to family members aggregating less than $200 in value per individual family member and charitable contributions aggregating less than $100 per recipient. (Married debtors filing under chapter 12 or chapter 13 must include gifts or contributions by either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) NAME AND ADDRESS OF PERSON OR ORGANIZATION RELATIONSHIP TO DEBTOR, IF ANY DESCRIPTION AND VALUE OF GIFT

DATE OF GIFT

_____________________________________________________________________________________________________ 8.
None

Losses

List all losses from fire, theft, other casualty or gambling within one year immediately preceding the commencement of this case or since the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include losses by either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) DESCRIPTION AND VALUE OF PROPERTY DESCRIPTION OF CIRCUMSTANCES AND, IF LOSS WAS COVERED IN WHOLE OR IN PART BY INSURANCE, GIVE PARTICULARS

DATE OF LOSS

______________________________________________________________________________________________________

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9.
None

Payments related to debt counseling or bankruptcy

List all payments made or property transferred by or on behalf of the debtor to any persons, including attorneys, for consultation concerning debt consolidation, relief under the bankruptcy law or preparation of a petition in bankruptcy within one year immediately preceding the commencement of this case. DATE OF PAYMENT, NAME OF PAYER IF OTHER THAN DEBTOR AMOUNT OF MONEY OR DESCRIPTION AND VALUE OF PROPERTY

NAME AND ADDRESS OF PAYEE

______________________________________________________________________________________________________ 10. Other transfers
None

a. List all other property, other than property transferred in the ordinary course of the business or financial affairs of the debtor, transferred either absolutely or as security within two years immediately preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include transfers by either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) NAME AND ADDRESS OF TRANSFEREE, RELATIONSHIP TO DEBTOR DATE DESCRIBE PROPERTY TRANSFERRED AND VALUE RECEIVED

______________________________________________________________________________________________________
None

G

b. List all property transferred by the debtor within ten years immediately preceding the commencement of this case to a self-settled trust or similar device of which the debtor is a beneficiary. NAME OF TRUST OR OTHER DEVICE DATE(S) OF TRANSFER(S) AMOUNT OF MONEY OR DESCRIPTION AND VALUE OF PROPERTY OR DEBTOR'S INTEREST IN PROPERTY

______________________________________________________________________________________________________ 11. Closed financial accounts
None

List all financial accounts and instruments held in the name of the debtor or for the benefit of the debtor which were closed, sold, or otherwise transferred within one year immediately preceding the commencement of this case. Include checking, savings, or other financial accounts, certificates of deposit, or other instruments; shares and share accounts held in banks, credit unions, pension funds, cooperatives, associations, brokerage houses and other financial institutions. (Married debtors filing under chapter 12 or chapter 13 must include information concerning accounts or instruments held by or for either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) TYPE OF ACCOUNT, LAST FOUR DIGITS OF ACCOUNT NUMBER, AND AMOUNT OF FINAL BALANCE AMOUNT AND DATE OF SALE OR CLOSING

NAME AND ADDRESS OF INSTITUTION

______________________________________________________________________________________________________

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12. Safe deposit boxes
None

List each safe deposit or other box or depository in which the debtor has or had securities, cash, or other valuables within one year immediately preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include boxes or depositories of either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) NAME AND ADDRESS OF BANK OR OTHER DEPOSITORY NAMES AND ADDRESSES OF THOSE WITH ACCESS TO BOX OR DEPOSITORY DESCRIPTION OF CONTENTS DATE OF TRANSFER OR SURRENDER, IF ANY

_ ______________________________________________________________________________________________________ 13. Setoffs
None

List all setoffs made by any creditor, including a bank, against a debt or deposit of the debtor within 90 days preceding the commencement of this case. (Married debtors filing under chapter 12 or chapter 13 must include information concerning either or both spouses whether or not a joint petition is filed, unless the spouses are separated and a joint petition is not filed.) DATE OF SETOFF AMOUNT OF SETOFF

NAME AND ADDRESS OF CREDITOR

_____________________________________________________________________________________________________ 14. Property held for another person
None

List all property owned by another person that the debtor holds or controls.

NAME AND ADDRESS OF OWNER

DESCRIPTION AND VALUE OF PROPERTY

LOCATION OF PROPERTY

_____________________________________________________________________________________________________ 15. Prior address of debtor
None

G

If debtor has moved within three years immediately preceding the commencement of this case, list all premises which the debtor occupied during that period and vacated prior to the commencement of this case. If a joint petition is filed, report also any separate address of either spouse.

ADDRESS

NAME USED

DATES OF OCCUPANCY

_____________________________________________________________________________

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16. Spouses and Former Spouses
None

If the debtor resides or resided in a community property state, commonwealth, or territory (including Alaska, Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington, or Wisconsin) within eight years immediately preceding the commencement of the case, identify the name of the debtor's spouse and of any former spouse who resides or resided with the debtor in the community property state. NAME

______________________________________________________________________________________________________ 17. Environmental Information. For the purpose of this question, the following definitions apply: "Environmental Law" means any federal, state, or local statute or regulation regulating pollution, contamination, releases of hazardous or toxic substances, wastes or material into the air, land, soil, surface water, groundwater, or other medium, including, but not limited to, statutes or regulations regulating the cleanup of these substances, wastes, or material. "Site" means any location, facility, or property as defined under any Environmental Law, whether or not presently or formerly owned or operated by the debtor, including, but not limited to, disposal sites. "Hazardous Material" means anything defined as a hazardous waste, hazardous substance, toxic substance, hazardous material, pollutant, or contaminant or similar term under an Environmental Law. ________________________________________________________________________________________________
None

a. List the name and address of every site for which the debtor has received notice in writing by a governmental unit that it may be liable or potentially liable under or in violation of an Environmental Law. Indicate the governmental unit, the date of the notice, and, if known, the Environmental Law: SITE NAME AND ADDRESS NAME AND ADDRESS OF GOVERNMENTAL UNIT DATE OF NOTICE ENVIRONMENTAL LAW

______________________________________________________________________________________________________
None

b. List the name and address of every site for which the debtor provided notice to a governmental unit of a release of Hazardous Material. Indicate the governmental unit to which the notice was sent and the date of the notice. SITE NAME AND ADDRESS NAME AND ADDRESS OF GOVERNMENTAL UNIT DATE OF NOTICE ENVIRONMENTAL LAW

_____________________________________________________________________________________________________
None

c. List all judicial or administrative proceedings, including settlements or orders, under any Environmental Law with respect to which the debtor is or was a party. Indicate the name and address of the governmental unit that is or was a party to the proceeding, and the docket number. NAME AND ADDRESS OF GOVERNMENTAL UNIT DOCKET NUMBER STATUS OR DISPOSITION

______________________________________________________________________________________________________ 18 . Nature, location and name of business
None

a. If the debtor is an individual, list the names, addresses, taxpayer-identification numbers, nature of the businesses, and beginning and ending dates of all businesses in which the debtor was an officer, director, partner, or managing executive of a corporation, partner in a partnership, sole proprietor, or was self-employed in a trade, profession, or other activity either full- or part-time within six years immediately preceding the commencement of this case, or in

8
which the debtor owned 5 percent or more of the voting or equity securities within six years immediately preceding the commencement of this case. If the debtor is a partnership, list the names, addresses, taxpayer-identification numbers, nature of the businesses, and beginning and ending dates of all businesses in which the debtor was a partner or owned 5 percent or more of the voting or equity securities, within six years immediately preceding the commencement of this case. If the debtor is a corporation, list the names, addresses, taxpayer-identification numbers, nature of the businesses, and beginning and ending dates of all businesses in which the debtor was a partner or owned 5 percent or more of the voting or equity securities within six years immediately preceding the commencement of this case. LAST FOUR DIGITS OF SOCIAL-SECURITY OR OTHER INDIVIDUAL TAXPAYER-I.D. NO. (ITIN)/ COMPLETE EIN

NAME

ADDRESS

NATURE OF BUSINESS

BEGINNING AND ENDING DATES

______________________________________________________________________________________________________
None

b. Identify any business listed in response to subdivision a., above, that is "single asset real estate" as defined in 11 U.S.C. § 101. NAME ADDRESS

______________________________________________________________________________________________________ The following questions are to be completed by every debtor that is a corporation or partnership and by any individual debtor who is or has been, within six years immediately preceding the commencement of this case, any of the following: an officer, director, managing executive, or owner of more than 5 percent of the voting or equity securities of a corporation; a partner, other than a limited partner, of a partnership, a sole proprietor, or self-employed in a trade, profession, or other activity, either full- or part-time. (An individual or joint debtor should complete this portion of the statement only if the debtor is or has been in business, as defined above, within six years immediately preceding the commencement of this case. A debtor who has not been in business within those six years should go directly to the signature page.) _____________________________________________________________________________________________________

19. Books, records and financial statements
None

a. List all bookkeepers and accountants who within two years immediately preceding the filing of this bankruptcy case kept or supervised the keeping of books of account and records of the debtor. NAME AND ADDRESS DATES SERVICES RENDERED

________________________________________________________________________________________________
None

b. List all firms or individuals who within two years immediately preceding the filing of this bankruptcy case have audited the books of account and records, or prepared a financial statement of the debtor. NAME ADDRESS DATES SERVICES RENDERED

_____________________________________________________________________________________________________

9
None

c. List all firms or individuals who at the time of the commencement of this case were in possession of the books of account and records of the debtor. If any of the books of account and records are not available, explain. NAME ADDRESS

________________________________________________________________________________________________
None

d. List all financial institutions, creditors and other parties, including mercantile and trade agencies, to whom a financial statement was issued by the debtor within two years immediately preceding the commencement of this case. NAME AND ADDRESS DATE ISSUED

________________________________________________________________________________________________ 20. Inventories
None

a. List the dates of the last two inventories taken of your property, the name of the person who supervised the taking of each inventory, and the dollar amount and basis of each inventory. DOLLAR AMOUNT OF INVENTORY (Specify cost, market or other basis)

DATE OF INVENTORY

INVENTORY SUPERVISOR

____________________________________________________________________________________________________
None

b. List the name and address of the person having possession of the records of each of the inventories reported in a., above. NAME AND ADDRESSES OF CUSTODIAN OF INVENTORY RECORDS

DATE OF INVENTORY

____________________________________________________________________________________________________ 21 . Current Partners, Officers, Directors and Shareholders
None

a. If the debtor is a partnership, list the nature and percentage of partnership interest of each member of the partnership. NAME AND ADDRESS NATURE OF INTEREST PERCENTAGE OF INTEREST

______________________________________________________________________________________________________
None

b. If the debtor is a corporation, list all officers and directors of the corporation, and each stockholder who directly or indirectly owns, controls, or holds 5 percent or more of the voting or equity securities of the corporation. NATURE AND PERCENTAGE NAME AND ADDRESS TITLE OF STOCK OWNERSHIP

__________________________________________________________________________________________________

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22 . Former partners, officers, directors and shareholders
None

a. If the debtor is a partnership, list each member who withdrew from the partnership within one year immediately preceding the commencement of this case. NAME ADDRESS DATE OF WITHDRAWAL

___________________________________________________________________________________________________
None

b. If the debtor is a corporation, list all officers or directors whose relationship with the corporation terminated within one year immediately preceding the commencement of this case. NAME AND ADDRESS TITLE DATE OF TERMINATION

___________________________________________________________________________________________________ 23 . Withdrawals from a partnership or distributions by a corporation
None

If the debtor is a partnership or corporation, list all withdrawals or distributions credited or given to an insider, including compensation in any form, bonuses, loans, stock redemptions, options exercised and any other perquisite during one year immediately preceding the commencement of this case. NAME & ADDRESS OF RECIPIENT, RELATIONSHIP TO DEBTOR AMOUNT OF MONEY OR DESCRIPTION AND VALUE OF PROPERTY

DATE AND PURPOSE OF WITHDRAWAL

___________________________________________________________________
24. Tax Consolidation Group.
None

If the debtor is a corporation, list the name and federal taxpayer-identification number of the parent corporation of any consolidated group for tax purposes of which the debtor has been a member at any time within six years immediately preceding the commencement of the case. NAME OF PARENT CORPORATION TAXPAYER-IDENTIFICATION NUMBER (EIN)

_____________________________________________________________________________________________________ 25. Pension Funds.
None

If the debtor is not an individual, list the name and federal taxpayer-identification number of any pension fund to which the debtor, as an employer, has been responsible for contributing at any time within six years immediately preceding the commencement of the case. NAME OF PENSION FUND TAXPAYER-IDENTIFICATION NUMBER (EIN)

* * * * * *

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[If completed by an individual or individual and spouse] I declare under penalty of perjury that I have read the answers contained in the foregoing statement of financial affairs and any attachments thereto and that they are true and correct.

Date __________________________ _____________________________________________

Signature of Debtor

Date __________________________

Signature_________________________________________ of Joint Debtor (if any)

__________________________________________________________________________________________________________________________

[If completed on behalf of a partnership or corporation] I declare under penalty of perjury that I have read the answers contained in the foregoing statement of financial affairs and any attachments thereto and that they are true and correct to the best of my knowledge, information and belief.

Date __________________________ __________________________________________________

Signature

_________________________________________________ Print Name and Title

[An individual signing on behalf of a partnership or corporation must indicate position or relationship to debtor.]

____ continuation sheets attached
Penalty for making a false statement: Fine of up to $500,000 or imprisonment for up to 5 years, or both. 18 U.S.C. §§ 152 and 3571

___________________________________________________________________________________________________
DECLARATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 U.S.C. § 110) I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined in 11 U.S.C. § 110; (2) I prepared this document for compensation and have provided the debtor with a copy of this document and the notices and information required under 11 U.S.C. §§ 110(b), 110(h), and 342(b); and, (3) if rules or guidelines have been promulgated pursuant to 11 U.S.C. § 110(h) setting a maximum fee for services chargeable by bankruptcy petition preparers, I have given the debtor notice of the maximum amount before preparing any document for filing for a debtor or accepting any fee from the debtor, as required by that section. _____________________________________________________ Printed or Typed Name and Title, if any, of Bankruptcy Petition Preparer _____________________________ Social-Security No. (Required by 11 U.S.C. § 110.)

If the bankruptcy petition preparer is not an individual, state the name, title (if any), address, and social-security number of the officer, principal, responsible person, or partner who signs this document. ________________________________ _________________________________ Address

X _____________________________________________________ Signature of Bankruptcy Petition Preparer

____________________ Date

Names and Social-Security numbers of all other individuals who prepared or assisted in preparing this document unless the bankruptcy petition preparer is not an individual: If more than one person prepared this document, attach additional signed sheets conforming to the appropriate Official Form for each person

A bankruptcy petition preparer's failure to comply with the provisions of title 11 and the Federal Rules of Bankruptcy Procedure may result in fines or imprisonment or both. 18 U.S.C. § 156.

B10 (Official Form 10) (12/07)
UNITED STATES BANKRUPTCY COURT ____________________DISTRICT OF___________________ Name of Debtor: Case Number: PROOF OF CLAIM

NOTE: This form should not be used to make a claim for an administrative expense arising after the commencement of the case. A request for payment of an administrative expense may be filed pursuant to 11 U.S.C. § 503. Name of Creditor (the person or other entity to whom the debtor owes money or property): Check this box to indicate that this claim amends a previously filed claim. Name and address where notices should be sent: Court Claim Number:______________ (If known) Telephone number: Name and address where payment should be sent (if different from above): Filed on:_____________________ Check this box if you are aware that anyone else has filed a proof of claim relating to your claim. Attach copy of statement giving particulars. Check this box if you are the debtor or trustee in this case. 5. Amount of Claim Entitled to Priority under 11 U.S.C. §507(a). If any portion of your claim falls in one of the following categories, check the box and state the amount. Specify the priority of the claim. Domestic support obligations under 11 U.S.C. §507(a)(1)(A) or (a)(1)(B). Wages, salaries, or commissions (up to $10,950*) earned within 180 days before filing of the bankruptcy petition or cessation of the debtor's business, whichever is earlier ­ 11 U.S.C. §507 (a)(4). Contributions to an employee benefit plan ­ 11 U.S.C. §507 (a)(5). Up to $2,425* of deposits toward purchase, lease, or rental of property or services for personal, family, or household use ­ 11 U.S.C. §507 (a)(7). Taxes or penalties owed to governmental units ­ 11 U.S.C. §507 (a)(8). Other ­ Specify applicable paragraph of 11 U.S.C. §507 (a)(__). Amount entitled to priority: $_______________ *Amounts are subject to adjustment on 4/1/10 and every 3 years thereafter with respect to cases commenced on or after the date of adjustment.
FOR COURT USE ONLY

Telephone number: 1. Amount of Claim as of Date Case Filed: $_______________________________

If all or part of your claim is secured, complete item 4 below; however, if all of your claim is unsecured, do not complete item 4. If all or part of your claim is entitled to priority, complete item 5. Check this box if claim includes interest or other charges in addition to the principal amount of claim. Attach itemized statement of interest or charges. 2. Basis for Claim: _____________________________ (See instruction #2 on reverse side.) 3. Last four digits of any number by which creditor identifies debtor: ______________________ 3a. Debtor may have scheduled account as: ____________________ (See instruction #3a on reverse side.) 4. Secured Claim (See instruction #4 on reverse side.) Check the appropriate box if your claim is secured by a lien on property or a right of setoff and provide the requested information. Nature of property or right of setoff: Describe: Real Estate Motor Vehicle Other

Value of Property:$________________ Annual Interest Rate___% Amount of arrearage and other charges as of time case filed included in secured claim, if any: $__________________ Basis for perfection: ____________________

Amount of Secured Claim: $__________________ Amount Unsecured: $__________________ 6. Credits: The amount of all payments on this claim has been credited for the purpose of making this proof of claim. 7. Documents: Attach redacted copies of any documents that support the claim, such as promissory notes, purchase orders, invoices, itemized statements or running accounts, contracts, judgments, mortgages, and security agreements. You may also attach a summary. Attach redacted copies of documents providing evidence of perfection of a security interest. You may also attach a summary. (See definition of "redacted" on reverse side.) DO NOT SEND ORIGINAL DOCUMENTS. ATTACHED DOCUMENTS MAY BE DESTROYED AFTER SCANNING. If the documents are not available, please explain:

Date: D

Signature: The person filing this claim must sign it. Sign and print name and title, if any, of the creditor or other person authorized to file this claim and state address and telephone number if different from the notice address above. Attach copy of power of attorney, if any.

Penalty for presenting fraudulent claim: Fine of up to $500,000 or imprisonment for up to 5 years, or both. 18 U.S.C. §§ 152 and 3571.

B10 (Official Form 10) (12/07) ­ Cont.
INSTRUCTIONS FOR PROOF OF CLAIM FORM The instructions and definitions below are general explanations of the law. In certain circumstances, such as bankruptcy cases not filed voluntarily by the debtor, there may be exceptions to these general rules. Items to be completed in Proof of Claim form documentation, and state annual interest rate and the amount past due Court, Name of Debtor, and Case Number: Fill in the federal judicial district where the bankruptcy case was filed (for on the claim as of the date of the bankruptcy filing. example, Central District of California), the bankruptcy debtor's name, and the bankruptcy case number. If the creditor received a notice of the case from the 5. Amount of Claim Entitled to Priority Under 11 U.S.C. §507(a). If any portion of your claim falls in one or more of the listed bankruptcy court, all of this information is located at the top of the notice. categories, check the appropriate box(es) and state the amount entitled to priority. (See DEFINITIONS, below.) A claim may be Creditor's Name and Address: Fill in the name of the person or entity asserting a claim and the name and address partly priority and partly non-priority. For example, in some of the of the person who should receive notices issued during the bankruptcy case. A categories, the law limits the amount entitled to priority. separate space is provided for the payment address if it differs from the notice address. The creditor has a continuing obligation to keep the court informed of its 6. Credits: current address. See Federal Rule of Bankruptcy Procedure (FRBP) 2002(g). An authorized signature on this proof of claim serves as an acknowledgment that when calculating the amount of the claim, the creditor gave the debtor credit for any payments received toward the debt. 1. Amount of Claim as of Date Case Filed: State the total amount owed to the creditor on the date of the Bankruptcy filing. Follow the instructions concerning whether to 7. Documents: complete items 4 and 5. Check the box if interest or other charges are Attach to this proof of claim form redacted copies documenting the existence included in the claim. of the debt and of any lien securing the debt. You may also attach a summary. You must also attach copies of documents that evidence perfection of any security interest. You may also attach a summary. FRBP 3001(c) and (d). 2. Basis for Claim: State the type of debt or how it was incurred. Examples include Do not send original documents, as attachments may be destroyed after goods sold, money loaned, services performed, personal scanning. injury/wrongful death, car loan, mortgage note, and credit card. Date and Signature: The person filing this proof of claim must sign and date it. FRBP 9011. If the 3. Last Four Digits of Any Number by Which Creditor Identifies claim is filed electronically, FRBP 5005(a)(2), authorizes courts to establish Debtor: local rules specifying what constitutes a signature. Print the name and title, if State only the last four digits of the debtor's account or other number any, of the creditor or other person authorized to file this claim. State the used by the creditor to identify the debtor. filer's address and telephone number if it differs from the address given on the top of the form for purposes of receiving notices. Attach a complete copy of 3a. Debtor May Have Scheduled Account As: Use this space to report a change in the creditor's name, a transferred any power of attorney. Criminal penalties apply for making a false statement claim, or any other information that clarifies a difference between this on a proof of claim. proof of claim and the claim as scheduled by the debtor. 4. Secured Claim: Check the appropriate box and provide the requested information if the claim is fully or partially secured. Skip this section if the claim is entirely unsecured. (See DEFINITIONS, below.) State the type and the value of property that secures the claim, attach copies of lien
__________DEFINITIONS__________ Debtor A debtor is the person, corporation, or other entity that has filed a bankruptcy case. Creditor A creditor is the person, corporation, or other entity owed a debt by the debtor on the date of the bankruptcy filing. Claim A claim is the creditor's right to receive payment on a debt that was owed by the debtor on the date of the bankruptcy filing. See 11 U.S.C. §101 (5). A claim may be secured or unsecured. Proof of Claim A proof of claim is a form used by the creditor to indicate the amount of the debt owed by the debtor on the date of the bankruptcy filing. The creditor must file the form with the clerk of the same bankruptcy court in which the bankruptcy case was filed. Secured Claim Under 11 U.S.C. §506(a) A secured claim is one backed by a lien on property of the debtor. The claim is secured so long as the creditor has the right to be paid from the property prior to other creditors. The amount of the secured claim cannot exceed the value of the property. Any amount owed to the creditor in excess of the value of the property is an unsecured claim. Examples of liens on property include a mortgage on real estate or a security interest in a car. A lien may be voluntarily granted by a debtor or may be obtained through a court proceeding. In some states, a court judgment is a lien. A claim also may be secured if the creditor owes the debtor money (has a right to setoff). Unsecured Claim An unsecured claim is one that does not meet the requirements of a secured claim. A claim may be partly unsecured if the amount of the claim exceeds the value of the property on which the creditor has a lien. Claim Entitled to Priority Under 11 U.S.C. §507(a) Priority claims are certain categories of unsecured claims that are paid from the available money or property in a bankruptcy case before other unsecured claims. Redacted A document has been redacted when the person filing it has masked, edited out, or otherwise deleted, certain information. A creditor should redact and use only the last four digits of any social-security, individual's taxidentification, or financial-account number, all but the initials of a minor's name and only the year of any person's date of birth. Evidence of Perfection Evidence of perfection may include a mortgage, lien, certificate of title, financing statement, or other document showing that the lien has been filed or recorded. ______INFORMATION______ Acknowledgment of Filing of Claim To receive acknowledgment of your filing, you may either enclose a stamped self-addressed envelope and a copy of this proof of claim or you may access the court's PACER system (www.pacer.psc.uscourts.gov) for a small fee to view your filed proof of claim. Offers to Purchase a Claim Certain entities are in the business of purchasing claims for an amount less than the fact value of the claims. One or more of these entities may contact the creditor and offer to purchase the claim. Some of the written communications from these entities may easily be confused with official court documentation or communications from the debtor. These entities do not represent the bankruptcy court or the debtor. The creditor has no obligation to sell its claim. However, if the creditor decides to sell its claim, any transfer of such claim is subject to FRBP 3001(e), any applicable provisions of the Bankruptcy Code (11 U.S.C. § 101 et seq.), and any applicable orders of the bankruptcy court.

B16A (Official Form 16A) (12/07)

Form 16A. CAPTION (FULL)

United States Bankruptcy Court
_______________ District Of _______________

In re __________________________________________, [Set forth here all names including married, maiden, and trade names used by debtor within last 8 years.] Debtor

) ) ) ) ) Case No. ________________ ) Address ________________________________________ ) ) ________________________________________ ) Chapter ___________ ) Last four digits of Social-Security or Individual TaxPayer-Identification (ITIN) No(s).,(if any): ___________ ) ______________________________________________ ) Employer Tax-Identification (EIN) No(s).(if any): _____ ) _______________________________________________ )

[Designation of Character of Paper]

B19 (Official Form 19) (12/07)

United States Bankruptcy Court
_______________ District Of _______________
In re _______________________________, Debtor Case No. _________________ Chapter ______________

DECLARATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER (See 11 U.S.C. § 110) I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined in 11 U.S.C. § 110; (2) I prepared the accompanying document(s) listed below for compensation and have provided the debtor with a copy of the document(s) and the attached notice as required by 11 U.S.C. §§ 110(b), 110(h), and 342(b); and (3) if rules or guidelines have been promulgated pursuant to 11 U.S.C. § 110(h) setting a maximum fee for services chargeable by bankruptcy petition preparers, I have given the debtor notice of the maximum amount before preparing any document for filing for a debtor or accepting any fee from the debtor, as required by that section. Accompanying documents: ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Printed or Typed Name and Title, if any, of Bankruptcy Petition Preparer: Social-Security No. of Bankruptcy Petition Preparer (Required by 11 U.S.C. § 110):

If the bankruptcy petition preparer is not an individual, state the name, title (if any), address, and social-security number of the officer, principal, responsible person, or partner who signs this document. _________________________________ _________________________________ Address X _______________________________ Signature of Bankruptcy Petition Preparer ____________________ Date

Names and social-security numbers of all other individuals who prepared or assisted in preparing this document, unless the bankruptcy petition preparer is not an individual:
If more than one person prepared this document, attach additional signed sheets conforming to the appropriate Official Form for each person. A bankruptcy petition preparer's failure to comply with the provisions of title 11 and the Federal Rules of Bankruptcy Procedure may result in fines or imprisonment or both. 11 U.S.C. § 110; 18 U.S.C. § 156.

B19 (Official Form 19) (12/07) - Cont.

2

NOTICE TO DEBTOR BY NON-ATTORNEY BANKRUPTCY PETITION PREPARER [Must be filed with any document(s) prepared by a bankruptcy petition preparer.] I am a bankruptcy petition preparer. I am not an attorney and may not practice law or give legal advice. Before preparing any document for filing as defined in § 110(a)(2) of the Bankruptcy Code or accepting any fees, I am required by law to provide you with this notice concerning bankruptcy petition preparers. Under the law, § 110 of the Bankruptcy Code (11 U.S.C. § 110), I am forbidden to offer you any legal advice, including advice about any of the following: · · · · · · · · · whether to file a petition under the Bankruptcy Code (11 U.S.C. § 101 et seq.); whether commencing a case under chapter 7, 11, 12, or 13 is appropriate; whether your debts will be eliminated or discharged in a case under the Bankruptcy Code; whether you will be able to retain your home, car, or other property after commencing a case under the Bankruptcy Code; the tax consequences of a case brought under the Bankruptcy Code; the dischargeability of tax claims; whether you may or should promise to repay debts to a creditor or enter into a reaffirmation agreement with a creditor to reaffirm a debt; how to characterize the nature of your interests in property or your debts; or bankruptcy procedures and rights.

[The notice may provide additional examples of legal advice that a bankruptcy petition preparer is not authorized to give.] In addition, under 11 U.S.C. § 110(h), the Supreme Court or the Judicial Conference of the United States may promulgate rules or guidelines setting a maximum allowable fee chargeable by a bankruptcy petition preparer. As required by law, I have notified you of this maximum allowable fee, if any, before preparing any document for filing or accepting any fee from you. ____________________________________ Signature of Debtor Date [In a joint case, both spouses must sign.] _______________________________ Joint Debtor (if any) Date

B21 (Official Form 21) (12/07)

STATEMENT OF SOCIAL-SECURITY NUMBER OR INDIVIDUAL TAXPAYER-IDENTIFICATION NUMBER (ITIN)
[Caption as in Form 16A.]

STATEMENT OF SOCIAL-SECURITY NUMBER(S) (or other Individual Taxpayer-Identification Number(s) (ITIN(s)))

1.Name of Debtor (Last, First, Middle):_______________________________ (Check the appropriate box and, if applicable, provide the required information.)

G Debtor has a Social-Security Number and it is: _ _ _-_ _-_ _ _ _ (If more than one, state all.) G Debtor does not have a Social-Security Number but has an Individual Taxpayer-Identification Number (ITIN), and it is: ___________________. (If more than one, state all.) G Debtor does not have either a Social-Security Number or an Individual Taxpayer-Identification Number (ITIN).
2.Name of Joint Debtor (Last, First, Middle):___________________________ (Check the appropriate box and, if applicable, provide the required information.)

G Joint Debtor has a Social-Security Number and it is: _ _ _-_ _-_ _ _ _ (If more than one, state all.) G Joint Debtor does not have a Social-Security Number but has an Individual Taxpayer-Identification Number (ITIN) and it is: ________________. (If more than one, state all.) G Joint Debtor does not have either a Social-Security Number or an Individual Taxpayer-Identification Number (ITIN).
I declare under penalty of perjury that the foregoing is true and correct. X ______________________________________________ Signature of Debtor Date ______________________________________________ Signature of Joint Debtor Date

X

______________________________________________________________________________ *Joint debtors must provide information for both spouses. Penalty for making a false statement: Fine of up to $250,000 or up to 5 years imprisonment or both. 18 U.S.C. §§ 152 and 3571.

B23 (Official Form 23) (12/07)

United States Bankruptcy Court
_______________ District Of _______________
In re ______________________________________, Debtor Case No. ___________________ Chapter ___________

DEBTOR'S CERTIFICATION OF COMPLETION OF POSTPETITION INSTRUCTIONAL COURSE CONCERNING PERSONAL FINANCIAL MANAGEMENT
Every individual debtor in a chapter 7, chapter 11 in which § 1141(d)(3) applies, or chapter 13 case must file this certification. If a joint petition is filed, each spouse must complete and file a separate certification. Complete one of the following statements and file by the deadline stated below: I, ___________________________________________, the debtor in the above-styled case, hereby (Printed Name of Debtor) certify that on __________________ (Date), I completed an instructional course in personal financial management provided by ________________________________________________________, an approved personal financial (Name of Provider) management provider. Certificate No. (if any):_________________________________. I, __________________________________________, the debtor in the above-styled case, hereby (Printed Name of Debtor) certify that no personal financial management course is required because of [Check the appropriate box.]: G Incapacity or disability, as defined in 11 U.S.C. § 109(h); G Active military duty in a military combat zone; or G Residence in a district in which the United States trustee (or bankruptcy administrator) has determined that the approved instructional courses are not adequate at this time to serve the additional individuals who would otherwise be required to complete such courses.

G

G

Signature of Debtor: _____________________________________ Date: _____________

_______________________________________________________________________________________________ Instructions: Use this form only to certify whether you completed a course in personal financial management. (Fed. R. Bankr. P. 1007(b)(7).) Do NOT use this form to file the certificate given to you by your prepetition credit counseling provider and do NOT include with the petition when filing your case. Filing Deadlines: In a chapter 7 case, file within 45 days of the first date set for the meeting of creditors under § 341 of the Bankruptcy Code. In a chapter 11 or 13 case, file no later than the last payment made by the debtor as required by the plan or the filing of a motion for entry of a discharge under § 1328(b) of the Code. (See Fed. R. Bankr. P. 1007(c).)

B24 (Official Form 24) (12/07)

[Caption as described in Fed. R. Bankr. P. 7010 or 9004(b), as applicable.]

CERTIFICATION TO COURT OF APPEALS BY ALL PARTIES A notice of appeal having been filed in the above-styled matter on _________[Date], ___________________, ________________________, and ______________________, [Names of all the appellants and all the appellees, if any], who are all the appellants [and all the appellees] hereby certify to the court under 28 U.S.C. § 158(d)(2)(A) that a circumstance specified in 28 U.S.C. § 158(d)(2) exists as stated below. Leave to appeal in this matter G is G is not required under 28 U.S.C. § 158(a). [If from a final judgment, order, or decree] This certification arises in an appeal from a final judgment, order, or decree of the United States Bankruptcy Court for the _________ District of ______________ entered on ____________[Date]. [If from an interlocutory order or decree] This certification arises in an appeal from an interlocutory order or decree, and the parties hereby request leave to appeal as required by 28 U.S.C. § 158(a). [The certification shall contain one or more of the following statements, as is appropriate to the circumstances.] The judgment, order, or decree involves a question of law as to which there is no controlling decision of the court of appeals for this circuit or of the Supreme Court of the United States, or involves a matter of public importance. Or The judgment, order, or decree involves a question of law requiring resolution of conflicting decisions. Or An immediate appeal from the judgment, order, or decree may materially advance the progress of the case or proceeding in which the appeal is taken.

B24 (Official Form 24) (12/07) - Cont.

Page 2

[The parties may include or attach the information specified in Rule 8001(f)(3)(C).]

Signed: [If there are more than two signatories, all must sign and provide the information requested below. Attach additional signed sheets if needed.] __________________________ Attorney for Appellant (or Appellant, if not represented by an attorney) __________________________ Printed Name of Signer __________________________ __________________________ Address __________________________ Telephone No. __________________________ Date ___________________________ Attorney for Appellee (or Appellee if not represented by an attorney) ___________________________ Printed Name of Signer ____________________________ ____________________________ Address ____________________________ Telephone No. ____________________________ Date